Donald P. Kotler

The 4th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV was held in San Diego, California, 22-25 September 2002, immediately before the 42nd ICAAC meeting. Of the two meetings, the most important presentations on lipodystrophy were at the workshop.

In general, the data presented were provocative but not definitive. There was progress in identifying the most relevant factors underlying the molecular and cellular changes associated with lipodystrophy, especially those related to protease inhibitors. The major focus of the workshop was on basic science, and very few treatment studies were presented. However, one theme that arose during the meeting was the concept that antiretroviral treatment may have several physiologic effects, some of which may be divergent.

This is a major confounding factor in the cross-sectional studies reported to date. However, results are becoming available from longitudinal studies of antiretroviral therapy, such as ACTG 384, and should further our knowledge of the development of lipodystrophy.

Including:

• Effects of antiretroviral agents on adipogenesis
• Effects of antiretroviral agents on glucose metabolism
• Effect of protease inhibitors on bone
• Basic science studies of atherogenesis
• Clinical studies of metabolic alterations
• Measurement of mitochondrial DNA
• Individual Susceptibility to Lipoatrophy
• Longitudinal Studies of Body Fat Distribution and HAART

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