Reports from the workshop

• The role of the metabolic syndrome in HIV
• Effect of lifestyle modification on risk factors for cardiovascular disease and metabolic syndrome
• Pioglitazone reduces peripheral lipatrophy and improves adipokines without reducing visceral fat
• Leptin reduces visceral abdominal tissue (VAT) without reducing limb fat
• Adipose tissue morphology improved after treatment discontinuation
• Incidence of lipodystrophy in Rwanda

This annual Workshop is the most important meeting for researchers, clinicians and advocates who focus on metabolic complications relating to management of HIV-positive patients.

While many studies reaffirmed the role of some ARVs in risk factors associated with lipodystrophy, cardiovascular disease and diabetes, there was further evidence on managing this risk by treatment choice. While lipoatrophy is now firmly linked to use of thymidine analogues and some degree of fat reversal occurs when switching to alternative drugs, notably tenofovir or abacavir, the mechanism to reverse fat accumulation is less clear.

Research into lipodystrophy over the last few years has increasingly focused on understanding adipogenesis as a dynamic process, and on the role of two major proteins produced by adipocytes: leptin and adiponectin, which act as hormones in their effect on different organs. At this years workshop, the role of inflammation by macrophage and lymphocyte activity in adipose tissue was also shown to be an increasingly important factor.

Although an interesting study suggested that leptin may be a useful treatment for reducing central fat accumulation, this research has been slow and leptin isn’t a clinical option at the moment. Prevention, through choice of initial treatment, switching treatment when necessary and lifestyle modification, was still stressed as the take-home message.

Clinical discussions included the role of the metabolic syndrome, and the high incidence of risk factors for insulin resistance and progression to type-2 diabetes in patients with HIV – and the degree to which this risk is underestimated.

For the first time, the organisers of the meeting have produced webcasts of many of the key presentations and discussions. This is a very positive and important step towards making medical research presented at the workshop available to a wider audience. Abstracts from the meeting together with webcasts of oral sessions and some slide presentations are posted on the conference website:

http://www.intmedpress.com/lipodystrophy