Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Current antiretroviral therapy has lead to longer survival in patients infected with HIV, but it is also associated with new and important problems. Body fat redistribution and metabolic abnormalities, the so-called lipodystrophy syndrome, are among the most prevalent and worrisome ones. While an increasing number of patients infected with HIV are becoming affected by this syndrome, the pathogenesis of this syndrome and how to prevent and treat the problem all remain largely unknown. Body fat changes stigmatise the bodies of patients infected with HIV giving them a similar look to that seen in patients some years ago when the wasting syndrome was more prevalent and HIV infection was ultimately fatal. The psychological impact of body fat changes may be severe enough to affect a patients' desire to continue with antiretroviral therapy. Metabolic abnormalities, probably with the exception of symptomatic diabetes mellitus and hypertriglyceridaemia-induced pancreatitis, do not have an immediate impact on the quality of the lives of patients with HIV. However, their potential long term cardiovascular and bone consequences may increase the morbidity and the mortality of patients infected with HIV through noninfectious diseases. The impact of lipodystrophy on patients infected with HIV is not readily captured with the classic instruments used to measure quality of life and hence it is necessary to modify them urgently. Though treating lipodystrophy seems fully justified, there is no proven treatment for this problem, although a number of treatments have been used with varying success. Despite the recognition that lipodystrophy may have important psychological repercussions, the best psychological approach for this problem is not known at present. Although lipodystrophy has its own peculiarities, existing knowledge about how to psychologically help other patients with deforming body changes might be of help for patients infected with HIV, or at least may act as a starting point.
 ...
PMID:Lipodystrophy syndrome in patients with HIV infection: quality of life issues. 1134 20

Widespread utilization of highly active antiretroviral therapy (HAART) for HIV-infection, primarily protease inhibitors in combination with nucleoside analogue reverse transcriptase inhibitors, has recently led to a sustained reduction in the morbidity and mortality of this disease. However, administration of HAART is frequently associated with the development of lipid disorders. The severity and prevalence of dyslipidaemia vary, depending on the type of HAART, nutritional status, HIV disease stage, and concomitant presence of lipodystrophy and insulin resistance (two additional adverse effects of HAART). The mechanism that is responsible for HAART-associated dyslipidaemia remains incompletely understood. Recent data indicate that this effect may be, at least in part, accounted for by protease inhibitor-mediated inhibition of the proteasome activity and accumulation of the active portion of sterol regulatory element-binding protein-1c in liver cells and adipocytes. Whether lipid disorders in HIV-infected patients receiving HAART translate into an increased cardiovascular risk, and the indications for lipid-lowering interventions in this population, remain to be established.
 ...
PMID:Antiretroviral therapy-associated hyperlipidaemia in HIV disease. 1135 35

The objectives of this study were to document the prevalence of facial lipodystrophy in patients with HIV infection receiving protease inhibitors and to identify associated factors. All patients with HIV infection receiving protease inhibitors seen at an HIV clinic in Hong Kong during a 2-month period, from August to October 1997, were assessed for facial lipodystrophy. Among 29 patients who had been receiving indinavir for 3 months or more, facial lipodystrophy was found in 7 (24%). Facial lipodystrophy in these patients was found to be an isolated event and was not associated with noticeable wasting elsewhere. The development of facial lipodystrophy was not found to be associated with age, sex, ethnicity, route of HIV transmission, CD4 cell count, history of AIDS-defining illness, or concurrent anti-retroviral treatment. Facial lipodystrophy was not observed in patients who had received indinavir for less than 3 months. The condition was also not found in patients taking other protease inhibitors, although this could be due to the small sample size. Prospective study of this condition with a larger sample and with objective anthropomorphic measurements would be desirable. In conclusion, facial lipodystrophy is a common occurrence among patients receiving indinavir, and physicians should be alerted to this condition.
 ...
PMID:Indinavir-associated facial lipodystrophy in HIV-infected patients. 1136 80

HIV patients taking protease inhibitors are sometimes reporting a wasting-related syndrome called lipodystrophy, Lipodystrophy is a condition in which the body does not process fats properly. Symptoms include loss of fat from the face and upper body, muscle loss in the arms and legs, pot belly, and abnormal fatty deposits referred to as buffalo humps. Diabetes occasionally occurs, and blood triglycerides are elevated. The syndrome was initially seen in patients on Crixivan, although use of other protease inhibitors can also cause this side effect. The forum for Collaborative AIDS Research is developing a clinical trial to learn more about this symptom. Patients experiencing the symptoms of lipodystrophy should contact the forum for Collaborative AIDS Research.
 ...
PMID:Metabolic problems and PIs. 1136 32

Unusual abnormalities continue to be reported among HIV patients on highly active antiretroviral therapy (HAART), with many of these symptoms being reported worldwide. One of the most distressing symptoms is abnormal redistribution of body fat (lipodystrophy). There is no clear-cut cause identified with lipodystrophy, and the reported prevalence ranges from 5 percent to more than 60 percent. Australian studies forecast that nearly all protease inhibitor patients will experience metabolic abnormalities as a result of their treatment. Possible drug mechanisms that may lead to these abnormalities are described. Another study suggests that these metabolic abnormalities may be a form of post-traumatic stress syndrome, based on observing similar symptoms in survivors of leukemia and breast cancer. Possible treatments and prevention options for these abnormalities are discussed.
 ...
PMID:Debate widens over protease inhibitor side effects. 1136 22

Researchers at the 12th World AIDS Conference in Geneva shared information on HIV lipodystrophy syndrome (LDS), addressing the difficulty in defining and understanding the condition. Researchers discussed the prevalence of LDS, its endocrinology, and suggested possible causes. There is uncertainty as to which anti-HIV drugs may cause LDS and whether switching drug regimens once LDS is diagnosed will reverse the condition. Evidence is now suggesting that there is little chance that diabetes is being caused by protease inhibitors, however, hyperlipidemia appears to be more common than expected. Studies investigating if physiological or endocrinological abnormalities may cause LDS have not shown any consistent changes to indicate that a specific mechanism may be the cause.
Hopkins HIV Rep 1998 Sep
PMID:Fat city: understanding HIV lipodystrophy. 1136 74

The 12th World AIDS Conference in Geneva provided evidence that STD prophylaxis/treatment does not reduce HIV transmission. New guidelines for antiretroviral therapy in terms of when to treat and when to change are also presented. Research findings and practical applications are also provided for the following areas: HIV therapeutic monitoring, immune reconstitution, prevention, TMP-SMX prophylaxis, lipodystrophy, serum lipid changes, and diabetes.
Hopkins HIV Rep 1998 Sep
PMID:Conference news at a glance. 1136 77

Presentations at the 12th World AIDS Conference underscored the value of highly active anti-retroviral therapy (HAART) in managing HIV. One of the main issues was not whether to use HAART, but when to begin using it. Data presented from several studies showed that a group of latently infected CD4 cells is continually present in the lymph nodes, despite long courses of treatment with HAART. Incidences of side effects such as lipodystrophy, diabetes, and high blood fat levels have been reported by many studies, although a specific connection of these side effects to protease inhibitors has not been established. Also presented were studies comparing different treatment regimens. Deciding which treatment regimen is most appropriate should be made individually, based on a strategy of progressive steps with an experienced physician. Drugs which are currently set for approval by the Food and Drug Administration were also discussed, as were newer drugs that are now being tested. In addition, drug resistance was addressed. The two tests that can indicate if there may be drug resistance are called genotype testing and phenotype testing.
 ...
PMID:STEP's 12th World AIDS Conference report. 1136 29

Lipodystrophy is a metabolic phenomena that results in abnormal body composition changes. The causes of lipodystrophy, how it appears and its consequences, and possible treatments are explored. Anecdotal reports show some success in treating lipodystrophy with recombinant human growth hormone (serostim), which has been shown to increase lean body mass as well as improve the quality of life for HIV-positive patients. Oxandrolone may also be a treatment option, due to reports which suggest that long term use can result in increased body mass.
 ...
PMID:Body composition changes with protease therapy. 1136 95

The Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) devoted considerable time to discussing lipodystrophy syndrome, which is characterized by an unusual distribution of fat. Patients began reporting these symptoms approximately 2 years ago, coinciding with the advent of aggressive protease inhibitors. Many concluded that protease inhibitors were somehow related to these symptoms. Because of recent research, that theory may be weakening. Serono Laboratories sponsored a seminar that noted a strong link between lipodystrophy and people with more advanced HIV infection who are faring well on Highly Active Antiretroviral Therapy (HAART). There is still little agreement on the definition of the syndrome and its relationship to serum lipid and glucose abnormalities. There are also concerns that heightened awareness of the problem may be leading to reports of lipodystrophy even when the changes in weight or body shape are minimal.
 ...
PMID:Phat phacts. 1136 79


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>