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  3rd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV
Athens, Greece - October 2001
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Pre-Conference Overview
Monday October 22
Written by Jules Levin
  Its 12 midnight here and since I'm having a little trouble sleeping here is a preliminary report based on a preview reading of the program and abstracts for this meeting. In tune with the theme of being in Greece, all the Lipodystrophy research gods are here for this meeting. Some interesting and potentially promising new information/research developments are reflected in my reading of the abstracts. Note that these are just mr preliminary observations which may change as we move through the conference and here and see more reporting on these abstracts.
There are several abstracts reporting preliminary positive results from early studies of Metformin, oxymetholone (a testosterone derivative), pioglitazone, and rosiglitazone for the treatment of lipodystrophy.
One abstract raises concern about the severity and prevalence for the development of anemia for HIV+ patients undergoing treatment for hepatitis c. The authors related higher incidence of anemia for patient taking AZT than d4T.
Several abstracts look at indinavir in vitro, in rats, and in single doses og indinavir in HIV- persons and report finding indinavir reduces glucose disposal. This suggests that indinavir plays a role in leading to insulin resistance and glucose or sugar increases. As you know insulin resistance is suggested as playing a potentially contributory role in body changes. There appears to be incremental progress in understanding the relationship between insulin resistance and body changes.
In looking at the 006 study comparing efavirenz+AZT/3TC to indinavir+AZT/3TC, a preliminary look at body changes suggests both regimens can lead to abnormalities in peripheral fat and visceral fat but less negative effects were seen in efv arm than IDV arm.
There are several studies reported here on the relationship between NRTIs and body changes. Data presented here continues to suggest NRTIs and mitochondrial toxicity are associated with fat loss or lipoatrophy but the causal connection remains needing further strengthening.
There are several studies here linking HAART with hepatoxicity defined by liver enzyme elevations. This is not news. still lacking are studies looking at clear evaluations of changes in the liver from HAART which I feel requires liver biopsies before and after HAART.
An abstract here reports finding "treatment with pharmaceutical dose of HGH is associated with hepatic, as well as peripheral insulin resistance that might lead to hyoerglycemia". Dose of 3mg/day was evaluated in 5 patients. Perhaps lower or less frequent dosing may be safer.
In sum, there do not appear to be major breakthroughs in understanding or treating body changes. But early results from research reported here suggest incremental progress in understanding and perhaps in treating body changes. These observations are based on merely previewing the abstract book. Please wait until conference proceeds for more insight. NATAP reports from this meeting will be forthcoming from researchers present at this meeting.