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At the 9th annual Conference on
Retroviruses and Opportunistic Infections in Seattle February 24
- February 28, 2002, it was noted that protease inhibitor therapy
appears to be associated with body changes in some patients. It was
stressed at the meeting that hyperlipidemia is associated more with
the use of protease inhibitors, although it also may be seen with
efavirenz. However, fat redistribution is not always associated
with protease inhibitors and several researchers have documented fat
redistribution in patients that have never taken protease
inhibitors. A new theory has advanced the possibility that
lipoatrophy and fat accumulation may be different syndromes. There
appears to be a separation of lipodystrophy, fat accumulation and
combined syndromes.
HIV related lipodystrophy may be
caused by protease inhibitors interfering with a liver protein that
closely resembles a portion of the HIV protease gene. Since all
protease inhibitors currently in use are structurally similar, they
may all interfere with the proper function of this liver enzyme which
helps control fat levels in the blood. The syndrome has also been
associated with other antiretroviral medications.
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