Insulin Resistance, Lipodtstrophy & Decreased Body Mass Occurred More Often in HCV/HIV Coinfected than in HIV-infected in This Study
(abstract 654)
     --Better Research Needed

The findings in this study are not at all surprising but were expected but we need more studies like this to demonstrate the problems so we can begin to find solutions or treatment interventions. A better understanding of problems like this should lead to better selection of HIV treatment regimens hopefully resulting in better medical management of HCV/HIV coinfected. In early and later clinical trials drug companies & researchers need to test for HCV+ and to analyze metabolic parameters & other related information comparing HCV+ vs HCV- individuals.

Duong and colleagues investigated whether chronic HCV infection constitutes a risk factor for insulin resistance in HIV/HVC patients under HAART. As background info, Duong said its been demonstrated that patients with HCV have an increased risk for insulin resistance and type 2 adult onset diabetes possibly thru mechanisms involving fatty liver (steatosis) and hepatic iron content. So, the purpose of this study was to see if HCV increases risk for insulin resistance in HIV-infected patients. To qualify for this study patients had to be HCV+ and have a sustained increase in ALT that was at least 2 fold above normal.

In this cross-sectional study 28 HIV/HVC infected subjects, 76 HIV infected and 121 HVC infected controls were tested for insulin resistance and body mass index (BMI). In HIV/HVC and HIV infected individuals the presence of a peripheral lipoatrophy and lipid profile were assessed.

• HIV/HCV and HVC infected patients had a significant increase in insulin resistance when compared with only HIV-infected patients.
• Moreover, BMI was significantly decreased in HIV/ HVC patients in comparison with the HIV and HCV group.
• Lipoatrophy was significantly observed more frequently in HCV/HIV co-infected patients than in HIV infected patients. (48% versus 19.5%).
• In HIV/HCV patients, total cholesterol levels were significantly lower than in HIV patients.

The authors conclude that chronic HCV infection is a significant factor associated with the development of metabolic abnormalities and with modifications in body composition in HIV patients receiving antiretroviral treatment.