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Lipodystrophy and metabolic complications

Polylactic acid (New-Fill) repairs facial wasting and improves quality of life

Canadian study shows increased interventional cardiovascular procedures associated with HAART

New guidelines for the evaluation and management of dyslipidaemia in HIV patients on HAART (2003)

Treatments for lipoatrophy. Are there improvements? Are they noticeable?

Rosiglitazone significantly increases triglyceride and cholesterol levels and does not improve HAART-associated lipoatrophy

US approves and Europe rejects Serostim (recombinant growth hormone) for treatment of HIV-related wasting

5th International Workshop on Adverse Drug Reactions and Lipodystrophy, 8-11 July 2003, Paris

Underlying mechanisms: adipocytes and cytokines

More mitochondrial DNA depletion

IMT and cardiovascular risk

Reduced bone mineral density in HIV-positive women

Rosiglitazone with insulin resistance

Additional benefits of exercise with metformin

Mitochondrial toxicity with AZT and d4T – and benefits of switch to abacavir

Facial fat loss – measuring and treatment

Uridine treatment for mitochondrial toxicity

Breast enlargement in men and testosterone treatment

Treatment interruption: a real choice

HIV and heart disease: D:A:D prevalence rates show importance of accessing CVD risk in HIV patients

HAART increases body fat at first; both d4T and AZT lead to subsequent fat loss

Lipoatrophy improved by switching from d4T to abacavir

Metabolic abnormalities in protease inhibitor-treated and protease naïve children

High levels of gout may be linked to HAART

Protease inhibitor use and the incidence of diabetes mellitus in a large cohort of HIV-infected women

Statins and fibrates both relatively effective for PI-induced hyperlipidemia

Pioglitazone subjectively improves body shape abnormalities

Conference has strong emphasis on women

Approaches to treatment of lipodystrophy

Surgery for buffalo hump shows variable results depending on method

Other studies – nucleosides and switching to abacavir; importance of lipoatrophy and buffalo hump

HAART to HEART: cardiovascular risk in HIV

Alendronate, vitamin D and calcium are safe and effective treatment for HIV-associated bone loss

Bone loss and fat loss are closely related in HIV patients on HAART

Reduced testosterone levels in HIV-positive women

30-year study links vitamin A to risk of fracture in humans

Bone turnover elevated in HIV-positive patients and linked to duration of HAART

Protease inhibitors and cardiovascular outcomes in patients with HIV-1

HIV protease inhibitors promote atherosclerosis independent of dyslipidemia

HAART-associated hyperlipidaemia linked to low risk for cardiovascular disease (CVD)

Patient on human growth hormone develops tumours with growth hormone receptors

Review of trials shows testosterone increases lean body mass, and is most effective when given intramuscularly

An overview of the conference

Comparison of the efficacy and safety of tenofovir vs. d4T when used in combination with 3TC and efavirenz in ARV-naive patients

Adipose tissue alterations develop early in antiretroviral therapy

Perspectives on hormonal, mitochondrial and metabolic changes

IAS panel issues first guidelines for HIV and HIV drug-related metabolic complications (2002)

Lipodystrophy and adverse drug reaction data presented at the 42nd ICAAC

A range of treatments for facial lipoatrophy

Tamoxifen for male breast enlargement?

Diet can help reduce lipid levels in people with HAART-related dyslipemia

Lipodystrophy syndrome and self-assessment of wellbeing and physical appearance in HIV-positive patients

Triglyceride increase can predict lipodystrophy in HIV patients under highly active antiretroviral therapy

Paracardial fat in HIV-infected patient resembles pericardial effusion

Altered adipocyte differentiation associated with protease inhibitors and lipoatrophy

Study results shed light on cardiovascular risks: role of antiretrovirals and metabolism of lipids and sugars

Switch to abacavir improves lipoatrophy

Potential use of niacin to reduce intra-abdominal fat

Further benefits shown with New-Fill for facial atrophy

Lipodystrophy associated with lower CD4+ T cell counts

Leptin reverses lipodystrophy in diabetic patients

Meeting calls for NHS funding and training to provide repair treatment for people with facial lipoatrophy

Managing the metabolic side effects of antiretroviral therapy

Intensive diet and exercise regimen may help fight lipodystrophy

Endocrine disorders complicate ARV treatment

Fat distribution is strongly tied to metabolic disturbances in HIV lipodystrophy

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