A subsequent Reuter's story indicates that many if not all PI's are associated with the fat deposits:
HIV Drugs Linked To Unusual Fat Build-Up
NEW YORK (Reuters) -- Researchers around the
world are noticing an unusual side effect in HIV-infected
patients taking certain medications -- an accumulation of
fat on the back of the neck, shoulders, abdomen or other
areas not usually associated with weight gain.
That finding was reported by researchers from Georgia,
Maryland, and California in the US, as well as by
researchers in Canada and Australia, who presented their
findings at the 5th Conference on Retroviruses and
Opportunistic Infections in Chicago, Illinois this week.
Often the symptoms occur in patients taking protease
inhibitors, the new class of potent anti-HIV drugs, and
researchers say they may be due to metabolic changes
caused by the drugs.
In one study of 148 HIV-infected patients, 64% of
patients taking protease inhibitors developed
lipodystrophy, a condition in which subcutaneous fat
deposits are reduced in the face and limbs, but fat
accumulates on the abdomen. The condition developed
earlier in patients taking a combination of ritonavir and
saquinavir, appearing after 8 months of drug treatment
compared with 12 months for those taking indinavir,
according to Dr. David A. Cooper and colleagues at the
St. Vincent's Hospital, Garvan Institute of Medical
Research and the National Center in HIV Epidemiology
and Clinical Research in Sydney, Australia.
The patients with lipodystrophy tended to have higher
triglycerides, cholesterol, insulin and signs of insulin
resistance, a precursor to diabetes. Three patients had a
worsening of diabetes mellitus.
In Atlanta, Georgia, four cases were identified in which
HIV-infected patients developed lipomatosis, "an
uncommon condition observed primarily in men who
abuse alcohol," according to the researchers from Emory
University. "It is characterized by the abnormal
deposition of unencapsulated fat in the neck and shoulder
areas in a 'horse collar' distribution." All patients were
taking indinavir, some in combination with other drugs
including idovudine, lamivudine or stavudine.
Similar "buffalo hump" symptoms were seen in 7 out of
800 HIV-infected patients at an HIV clinic in Canada,
and all were taking at least one of saquinavir, ritonavir,
indinavir or nelfinavir.
"This finding was not specific to the use of a particular
protease inhibitor and it is not yet known whether
changing or discontinuing therapy would result in
regression of this mass," reported Dr. Virginia R. Roth
and colleagues from Ottawa General Hospital. "Until
more is known about the significance of this unique
finding, decisions regarding an adjustment in antiretroviral
therapy should be made on an individual basis." |
