The Reuter's story suggests that the Buffalo Humps are associated with protease inhibitors. Although one small (n=10) study did mention Crix, the problem seems to be rather widespread and I did not get the impression that it was solely due to Crix:
C H I C A G O, Feb. 4 - Scientists said
today they are intrigued by a series
of studies on unusual fat
deposits-given nicknames like the
"buffalo hump" and "protease
paunch"-developing in some people
taking drug cocktails to fight HIV
infection.
Ranging from "buffalo humps" on the
upper back under the neck to pot bellies
dubbed the "protease paunch," researchers
say they are finding that people given strong
new HIV drugs called protease inhibitors are
developing strange side-effects in the form of
fat.
"We report 10 patients who developed a
similar pattern of abdominal complaints three
or more months after starting indinavir
(Merck's protease inhibitor sold under the
name Crixivan)," Kirk Miller and colleagues
at the National Institute of Allergies and
Infectious Diseases (NIAID) in Bethesda,
Maryland, reported.
"CT scans showed excess visceral fat,"
they added-extra fat inside the abdomen.
May Not Be That Rare
Most researchers say it is rare but a team at
St. Vincent's Hospital in Sydney, Australia,
found 64 percent of their patients taking
protease inhibitors showed the strange
effect-a wasting of their arms and legs and
a buildup of dense fat around their middles.
They showed pictures-and it is clearly
not just weight gain. The fat deposits look
unusual. One team described a "fat
neck-like a football player" on an
otherwise thin 55-year-old male.
"Having seen several of these myself, they
can be very subtle," said John Mellors of the
University of Pittsburgh. But the patients are
noticing.
"Patients are coming to their physicians
and saying 'I don't look right-what is going
on?"'
Often, doctors are downright
unsympathetic. "I won't speak to more
cosmetically sensitive areas ... but in
Pittsburgh there is no quiche or fluff and if
viral levels are down it's good enough,"
Mellors told a news conference.
But he added later, "As patients' lives
change, as they go from wrestling with
having a fatal disease to having a future,
other issues become prominent."
Bad for Metabolism?
And the side-effect could point to something
serious, such as a metabolic defect. Long
use of protease inhibitors is also being linked
with diabetes and related conditions such as
high blood sugar and high blood cholesterol.
"When associated with insulin resistance
and hyperglycemia (high blood sugar) and
diabetes, it is obviously a first warning,"
Scott Hammer of Beth Deaconess Medical
Center and Harvard University said.
Some researchers pointed to other
worries, too.
"None of this has been fatal but it is
unfortunate," said Charles Farthing, director
of the AIDS Healthcare Foundation in Los
Angeles.
Some May Drop Drugs
He fears some patients may not stick to the
already difficult drug regimens. "The biggest
problem with people not taking drugs is
depression," he said in an interview.
"If they don't care whether they live or
die, they won't put up with the side-effects."
He added, only half-joking, "I am very
aggressive with the Prozac."
The doctors predicted the issue would
grow in importance.
"The prevalence of this disorder will
increase because individuals will start paying
attention to their own bodies and physicians
will start asking questions," Mellors
predicted.
"I'm going to start looking for it in my
patients," said Farthing. |
