by Eugene Jacquescoley DO PhD

Created on: September 04, 2008

HIV prevalence in the U.S. was 24% to 27% or 1,039,000 to 1,185,000 people (Centers for Disease Control, 2003). Within this population, the prevalence of HIV lipodystrophy was 2% to 60% of all patients who were HIV positive in 2007 (Robles et al, 2007). As protease inhibitors have a realized association with longevity in HIV patients, lipodystrophy is also getting a second look from the clinical and pharmaceutical communities. Refer to an excerpt from a case presentation of a 39y.o. Asian male who was initially diagnosed with AIDS and presently has a diagnosis of HIV lipodystrophy. "My doctors told me that a new drug, [indinavir], had been released. But I had to apply for that through a mail lottery system because it was not yet available on the market. I was accepted into the trial, and that is when my history of lipodystrophy started. It was a gradual change, and by the second year of being on [indinavir], I began to see the effects. I noticed that under my chin, I started getting fat retention, and my cheeks were becoming a bit sunken (Robles et al, 2007)."

Thousands of HIV patients have similar stories with regards to their body morphology. Whether attributed to lipathophy (localized loss of fat tissue) as described by Dr. Robles patient or lipohypertrophy (abnormal central fat accumulation) which has similar prevalence patterns. TH9507 a growth hormone promoter may show promise in reducing the symptoms associated with lipodystrophy in the near future.
Lipodystrophy, also called fat redistribution syndrome, is a condition that often occurs in HIV-positive people and is characterized by changes in body shape and metabolism. Body shape changes may include the accumulation and/or loss of fat, which can affect appearance. Metabolic changes may include increased resistance to insulin and abnormally high levels of blood cholesterol and triglycerides. These do not all necessarily occur together; each may occur separately or in any combination.

Even though it is not clear what the etiology of lipodystrophy; there is a renewed interest in collecting data and making useful observations. The endocrinology community seems to agree that there may a correlation with protease inhibitor therapy (the subsequent line of FDA approved ant-HIV medications) and nucleoside reverse transcriptase inhibitors (first class of drugs approved by the FDA). Based upon preliminary research that claims to understand the "mechanism of action" causing lipodystrophy o fat redistribution. Other

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