 |
|
|
| |
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.
|
|
| |
|
|
|
|
|
