Treatment options for lipodystrophy in HIV-positive patients

Expert Opinion on Pharmacotherapy

Volumn 9, Issue 1, 2008, Pages 39-52

  Behrens, Georg M N ^a  

^a HANNOVER MEDICAL SCHOOL   (Germany)

Author keywords

Adverse event; HAART; HIV therapy; Lipoatrophy; Lipodystrophy

Indexed keywords

ABACAVIR; ANTIDIABETIC AGENT; ANTIRETROVIRUS AGENT; ATORVASTATIN; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; EFAVIRENZ; FIBRIC ACID DERIVATIVE; GLITAZONE DERIVATIVE; HUMAN GROWTH HORMONE; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; INDINAVIR; LAMIVUDINE; LOPINAVIR PLUS RITONAVIR; METFORMIN; NICOTINIC ACID; NUCLEOSIDE ANALOG; PIOGLITAZONE; PLACEBO; PROTEINASE INHIBITOR; RITONAVIR; RNA DIRECTED DNA POLYMERASE INHIBITOR; ROSIGLITAZONE; STAVUDINE; STEROID; TENOFOVIR; THIAZIDE DIURETIC AGENT; TIPRANAVIR; UNINDEXED DRUG; URIDINE; ZIDOVUDINE;

ARTHRALGIA; BODY FAT DISTRIBUTION; CLINICAL TRIAL; COMPUTER ASSISTED TOMOGRAPHY; CORONARY ARTERY DISEASE; DIAGNOSTIC VALUE; DIET THERAPY; DOSAGE SCHEDULE COMPARISON; DOSE RESPONSE; DRUG BLOOD LEVEL; DRUG DOSE COMPARISON; DRUG DOSE INCREASE; DRUG DOSE REDUCTION; DRUG DOSE REGIMEN; DRUG EFFICACY; DRUG EXPOSURE; DRUG FATALITY; DRUG INDUCED HEADACHE; DRUG MECHANISM; DRUG METABOLISM; DRUG POTENTIATION; DRUG SUBSTITUTION; DRUG WITHDRAWAL; DUAL ENERGY X RAY ABSORPTIOMETRY; ECHOGRAPHY; HEART INFARCTION; HIGH RISK PATIENT; HIGHLY ACTIVE ANTIRETROVIRAL THERAPY; HIV ASSOCIATED LIPODYSTROPHY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; HYPERLIPIDEMIA; HYPERTENSION; IMPLANTATION; INCIDENCE; INFORMATION PROCESSING; LIFESTYLE MODIFICATION; LIMB PAIN; LIPOATROPHY; LIPODYSTROPHY; LIPOHYPERTROPHY; LIPOSUCTION; LIVER TOXICITY; METABOLIC SYNDROME X; MUSCLE DISEASE; NUCLEAR MAGNETIC RESONANCE IMAGING; PATHOGENESIS; PATIENT COMPLIANCE; PERIPHERAL EDEMA; PREDICTION; PREVALENCE; PRIMARY PREVENTION; QUALITY OF LIFE; REVIEW; RISK FACTOR; SENSITIVITY AND SPECIFICITY; VIRUS RESISTANCE;

ADENINE; ANTI-HIV AGENTS; ANTIRETROVIRAL THERAPY, HIGHLY ACTIVE; DIDEOXYNUCLEOSIDES; EXPERT TESTIMONY; HEALTH BEHAVIOR; HIV-ASSOCIATED LIPODYSTROPHY SYNDROME; HUMANS; LIPID METABOLISM; PHOSPHONIC ACIDS;

EID: 39049159591     PISSN: 14656566     EISSN: None     Source Type: Journal    
DOI: 10.1517/14656566.9.1.39     Document Type: Review

References (127)

1. Palella FJ Jr, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 1998;338(13):853-60
2. Harrington M, Carpenter CC. Hit HIV-1 hard, but only when necessary. Lancet 2000;355(9221):2147-52
3. Carr A, Samaras K, Thorisdottir A, et al. Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet 1999;353(9170):2093-9
4. Garg A. Acquired and inherited lipodystrophies. N Engl J Med 2004;350(12):1220-34
5. Carr A, Cooper DA. Images in clinical medicine. Lipodystrophy associated with an HIV-protease inhibitor. N Engl J Med 1998;339(18):1296
6. Carr A, Samaras K, Burton S, et al. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS 1998;12(7):F51-F58
7. Carr A. HIV lipodystrophy: risk factors, pathogenesis, diagnosis and management. AIDS 2003;17(Suppl 1):S141-S148
8. Grinspoon S, Carr A. Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med 2005;352(1):48-62
9. Dube MP, Parker RA, Tebas P, et al. Glucose metabolism, lipid, and body fat changes in antiretroviral-naive subjects randomized to nelfinavir or efavirenz plus dual nucleosides. AIDS 2005;19(16):1807-18
10. Mallon PW, Miller J, Cooper DA, Carr A. Prospective evaluation of the effects of antiretroviral therapy on body composition in HIV-1-infected men starting therapy. AIDS 2003;17(7):971-9
11. Kosmiski L, Kuritzkes D, Hamilton J, et al. Fat distribution is altered in HIV-infected men without clinical evidence of the HIV lipodystrophy syndrome. HIV Med 2003;4(3):235-40
12. Mulligan K, Parker RA, Komarow L, et al. Mixed patterns of changes in central and peripheral fat following initiation of antiretroviral therapy in a randomized trial. J Acquir Immune Defic Syndr 2006;41(5):590-7
13. Stocker DN, Meier PJ, Stoller R, Fartinger KE. "Buffalo hump" in HIV-1 infection. Lancet 1998;352(9124):320-1
14. Driscoll SD, Meininger GE, Ljungquist K, et al. Differential effects of metformin and exercise on muscle adiposity and metabolic indices in human immunodeficiency virus-infected patients. J Clin Endocrinol Metab 2004;89(5):2171-8
15. Torriani M, Hadigan C, Jensen ME, Grinspoon S. Psoas muscle attenuation measurement with computed tomography indicates intramuscular fat accumulation in patients with the HIV-lipodystrophy syndrome. J Appl Physiol 2003;95(3):1005-10
16. Sutinen J, Hakkinen AM, Westerbacka. J, et al. Increased fat accumulation in the liver in HIV-infected patients with antiretroviral therapy-associated lipodystrophy. AIDS 2002;16(16):2183-93
17. Grinspoon SK. Metabolic syndrome and cardiovascular disease in patients with human immunodeficiency virus. Am J Med 2005; 118(Suppl 2):S23-S28
18. Grinspoon S. Mechanisms and strategies for insulin resistance in acquired immune deficiency syndrome. Clin Infict Dis 2003;37(Suppl 2)S85-S90
19. John M, Nolan D, Mallal S. Antiretroviral therapy and the lipodystrophy syndrome. Antivir Ther 2001;6(1):9-20
20. Nolan D, John M, Mallal S. Antiretoviral therapy and the lipodystrophy syndrome, part 2: concepts in aetiopathogenesis. Antivir Ther 2001;6(3):145-60
21. Behrens GM, Meyer-Olson D, Stoll M, Schmidt RE. Clinical impact of HIV-related lipodystrophy and metabolic abnormalities on cardiovascular disease. AIDS 2003;17(Suppl 1):S149-S154
22. Gougeon ML, Penicaud L, Fromenty B, et al. Adipocytes targets and actors in the pathogenesis of HIV-associated lipodystrophy and metabolic alterations. Antivir Ther 2004;9(2):161-77
23. Dube MP, Stein JH, Aberg JA, et al. Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis 2003;37(5):613-27
24. Wohl DA, Mccomsey G, Tebas P, et al. Current concepts in the diagnosis and management of metabolic complications of HIV infection and its therapy. Clin Infect Dis 2006;43(5):645-53
25. Carr A, Law M. An objective lipodystrophy severity grading scale derived from the lipodystrophy case definition score. J Acquir Immune Defic Syndr 2003;33(5):571-6
26. The National Centre in HIV Epidemiology and Clinical Research. Available from: http://www.med.unsw.edu.au/nchecr
27. Bacchetti P, Gripshover B, Grunfeld C, et al. Fat distribution in men with HIV infection. J Acquir Immune Defic Syndr 2005;40(2):121-31
28. Asensi V, Martin-Roces E, Collazos J, et al. Association between physical and echographic fat thickness assessments and a lipodystrophy grading scale in lipodystrophic HIV patients: practical implications. AIDS Res Hum Retroviruses 2006;22(9):830-6
29. Shlay JC, Bartsch G, Peng G, et al. Long-term body composition and metabolic changes in antiretroviral naive persons randomized to protease inhibitor-, nonnucleoside reverse transcriptase inhibitor-, or protease inhibitor plus nonnucleoside reverse transcriptase inhibitor-based strategy. J Acquir Immune Defic Syndr 2007;44(5):506-17
30. Asensi V, Martin-Roces E, Carton JA, et al. Perirenal fat diameter measured by echography could be an early predictor of lipodystrophy in HIV type 1-infected patients receiving highly active antiretroviral therapy Clin Infect Dis 2004;39(2):240-7
31. Martinez E, Garcia-Viejo MA, Blanch L, Gatell JM. Lipodystrophy syndrome in patients with HIV infection: quality of life issues. Drug Saf 2001;24(3):157-66
32. Oette M, Juretzko P, Kroidl A, et al. Lipodystrophy syndrome and self-assessment of well-being and physical appearance in HIV-positive patients. AIDS Patient Care STDS 2002;16(9):413-17
33. Duran S, Saves M, Spire B, et al. Failure to maintain long-term adherence to highly active antiretroviral therapy: the role of lipodystrophy. AIDS 2001;15(18):2441-4
34. Collins E, Wagner C, Walmsley S. Psychosocial impact of the lipodystrophy syndrome in HIV infection. AIDS Read 2000;10(9):546-50
35. Wand H, Calmy A. Carey D, et al. Matabolic syndrome, cardiovascular disease and type 2 diabetes mellinis after initiation of antiretroviral therapy in HIV-infected adults. Antivir Ther 2006;11:L4
36. Samaras K, Wand H, Law M, et al. Prevalence of metabolic syndrome in HIV-infected patients receiving highly active antiretroviral therapy using International Diabetes Foundation and Adult Treatment Panel III criteria: associations with insulin resistance, disturbed body fat compartmentalization, elevated C-reactive protein, and [corrected] hypoadiponectinemia. Diabetes Care 2007;30(1):113-19
37. Grunfeld C, Rimland D, Gibert C, et al. Insulin resistance is independently associated with VAT and upper trunk SAT in controls and HIV infection. Antiviral Ther 2006;11:L5
38. Murata H, Hruz PW, Mueckler M. Indinavir inhibits the glucose transporter isoform Glut4 at physiologic concentrations. AIDS 2002;16(6):859-63
39. Behrens GM, Boerner AR, Weber K, et al. Impaired glucose phosphorylation and transport in skeletal muscle cause insulin resistance in HIV-1-infected patients with lipodystrophy. J Clin Invest 2002;110(9):1319-27
40. Friis-Moller N, Weber R, Reiss P, et al. Cardiovascular disease risk factors in HIV patients - association with antiretroviral therapy. Results from the DAD study. AIDS 2003;17(8):1179-93
41. Gazzaruso C, Bruno R, Garzaniti A, et al. Hypertension among HIV patients: prevalence and relationships to insulin resistance and metabolic syndrome. J Hypertens 2003;21(7):1377-82
42. Sattler FR, Quin D, Louie S, et al. Elevated blood pressure in subjects with lipodystrophy. AIDS 2001;15(15):2001-10
43. Thiebaut R, El Sadr WM, Friis-Moller N, et al. Predictors of hypertension and changes of blood pressure in HIV-infected patients. Antivir Ther 2005;10(7):811-23
44. Hadigan C, Meigs JB, Rabe J, et al. Increased PAI-1 and tPA antigen levels are reduced with metformin therapy in HIV-infected patients with fat redistribution and insulin resistance. J Clin Endocrinol Metab 2001;86(2):939-43
45. Friis-Moller N, Sabin CA, Weber R, et al. Combination antiretroviral therapy and the risk of myocardial infarction. N Engl J Med 2003;349(21):1993-2003
46. Friis-Moller N, Reiss P, Sabin CA, et al. Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med 2007;356(17):1723-35
47. El Sadr WM, Lundgren JD, Neaton JD, et al. CD4+ count-guided interruption of antiretroviral treatment. N Engl J Med 2006;355(22):2283-96
48. Mercie P, Thiebaut R, Lavignolle V, et al. Evaluation of cardiovascular risk factors in HIV-1 infected patients using carotid intima-media. thickness measurement. Ann Med 2002;34(1):55-63
49. Currier JS, Kendall MA, Zackin R, et al. Carotid artery intima-media thickness and HIV infection: traditional risk factors overshadow impact of protease inhibitor exposure. AIDS 2005;19(9):927-33
50. Behrens GM. Cardiovascular risk and body-far abnormalities in HIV-infected adults. N Engl J Med 2005;352(16):1721-2
51. Law MG, Friis-Moller N, El Sadr WM, et al. The use of the Framingham equation to predict myocardial infarctions in HIV-infected patients: comparison with observed events in the D:A:D Study. HIV Med 2006;7(4):218-30
52. Carr A, Workman C, Smith DE, et al. Abacavir substitution for nucleoside analogs in patients with HIV lipoatrophy. a randomized trial. JAMA 2002;288(2):207-15
53. Mccomsey GA, Ward DJ, Hessenthaler SM, et al. Improvement in lipoatrophy associated with highly active antiretroviral therapy in human immunodeficiency virus-infected patients switched from stavudine to abacavir or zidovudine: the results of the TARHEEL study. Clin Infect Dis 2004;38(2):263-70
54. Moyle GJ, Baldwin C, Langroudi B, et al. A 48-week, randomized, open-label comparison of three abacavir-based substitution approaches in the management of dyslipidemia and peripheral lipoatrophy. J Acquit Immune Defic Syndr 2003;33(1):22-28
55. Murphy RL, Smith WJ. Switch studies: a review. HIV Med 2002;3(2):146-55
56. John M, Mckinnon EJ, James IR, et al. Randomized, controlled, 48-week study of switching stavudine and/or protease inhibitors to combivir/ abacavir to prevent or reverse lipoatrophy in HIV-infected patients. J Acquit Immune Defic Syndr 2003;33(1):29-33
57. Martin A. Smith DE, Carr A. et al. Reversibility of lipoatrophy in HIV-infected patients 2 years after switching from a thymidine analogue to abacavir: the MITOX Extension Study. AIDS 2004;18(7):1029-36
58. Madruga JVR, Cassetti I, Suleiman JMAH, et al. Switch from (d4T) to tonofovir DF (TDF) in combination with lamivudine (3TC) and efavirnez (EFV) resulted in continued virological suppression and improvement in lipoatrophy through 2 years in HIV-infected patients. Antivir Ther 2006;11:L21
59. Tebas P, Zhang J, Yarasheski K, et al. Switching to a protease inhibitor-containing, nucleoside-sparing regimen (lopinavir/ritonavir plus efavirenz) increases limb far but raises serum lipid levels: results of a prospective randomized trial (AIDS clinical trial group 5125s). J Acquir Immune Defic Syndr 2007;45(2):193-200
60. Milinkovic A. Martinez E, Lopez S, et al. The impact of reducing stavudine dose versus switching to tenofovir on plasma lipids, body composition and mitochondrial function in HIV-infected patients. Antivir Ther 2007;12(3):407-15
61. Moyle GJ, Sabin CA, Cartledge J, et al. A randomized comparative trial of tenofovir DF or abacavir as replacement for a thymidine analogue in persons with lipoatrophy. AIDS 2006;20(16):2043-50
62. Carr A, Zajdenverg R, Workman C, et al. Effects of tipranavir/r (500/200 or 500/100 mg BID) in comparison with lopinavir/r (400/100 mg BID) on changes in body composition and metabolic parametem in ARV-naïve patients over 48 weeks. Antivir Ther 2007;12(Suppl 2):L8
63. Wohl D, Lancaster T, Dejesus E, et al. Determination of body composition by total body DEXA after 48 weeks of treatment with once-daily fosamprenavir (FPV) boosted with tow different doses of ritonavir (r) plus abacavir (ABC)/lamivudine (3TC): COL100758. 4th IAS Conference on HIV Pathogenesis, Treatment and Prevention; 2007 July 22-25; Sydney, Australia [Abstract TUBEB080]
64. Dube MP, Komarow L, Mulligan K, et al. Long-term body fat outcomes in antiretroviral-naive participants randomized to nelfinavir or efavirenz or both plus dual nucleosides. Dual X-ray absorptiometry results from A5005s, a substudy of Adult Clinical Trials Group 384. J Acquir Immune Defic Syndr 2007;45(5):508-14
65. Haubrich RH, Riddler S, Dirienzo G, et al. Metabolic Outcomes of ACTG 5142: A prospective, randomized, Phase III trial of NRTI-, PI-, and NNRTI-sparing regimens for inital treatment of HIV-1 infection. 14th Conference on Retroviruses and Opportunistic Infections; 2007 February 25-28; Los Angeles, USA (Abstract 38)
66. Cameron DW, Da Silva B, Arrribas J, et al. Significant sparing of peripheral lipoatrophy by HIV treatment with LPV/r+ZDV/3TC induction followed by LPV/r monotherapy compared with EFV+ZDV/3TC. 14th Conference on Retroviruses and Opportunistic Infections; 2007 February 25-28; Los Angeles, USA (Abstract 44)
67. Walker UA, Brinkman K. NRTI induced mitochondrial toxicity as a mechanism for HAART relared lipodystrophy: fact or fiction? HIV Med 2001;2(3):163-5
68. Walker UA, Venhoff N, Koch EC, et al. Uridine abrogates mitochondrial toxicity related to nucleoside analogue reverse transcriptase inhibitors in HepG2 cells. Antivir Ther 2003;8(5):463-70
69. Walker UA, Venhoff N. Uridine in the prevention and treatment of NRTI-related mitochondrial toxicity. Antivir Ther 2005;10(Suppl 2):M117-M123
70. Sutinen J, Walker UA, Sevastianova K, et al. Uridine supplementation for the treatment of antiretroviral therapy-associated lipoatrophy: a randomized, double-blind, placebo-controllcd trial. Antivir Ther 2007;12:97-105
71. Walli R, Michl GM, Muhlbayer D, et al. Effects of troglitazone on insulin sensitivity in HIV-infected patients with protease inhibitor-associated diabetes mellitus. Res Exp Med (Berl) 2000;199(5):253-62
72. Gelato MC, Mynarcik DC, Quick JL, et al. Improved insulin sensitivity and body fat distribution in HIV-infectcd patients treated with rosiglitazone: a pilot study. J Acquir Immune Defic Syndr 2002;31(2):163-70
73. Mulligan Y, Yang Y, Wininger DA, et al. Effects of metformin and rosiglitazone in HIV-infected patients with hyperinsulinemia and elevated waist/hip ratio. AIDS 2007;21(1):47-57
74. Sutinen J, Hakkinen AM, Westerbacka J, et al. Rosiglitazone in the treatment of HAART-associated lipodystrophy - a randomized double-blind placebo-controlled study. Antivir Ther 2003;8(3):199-207
75. Carr A, Workman C, Carey D, et al. No effect of rosiglitazone fbr treatment of HIV-1 lipoatrophy. randomised, double-blind, placebo-controlled trial. Lancet 2004;363(9407):429-38
76. Hadigan C, Yawetz S, Thomas A, et al. Metabolic effects of rosiglitazone in HIV lipodystrophy. a randomized, controlled trial. Ann Intern Med 2004;140(10):786-94
77. Maachi M, Slama L, Lanoy E, et al. Effect of pioglitazone on limb fat and circulating adipokines in HIV-related lipodystrophy. Antivir Ther 2006;11:L16
78. Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med 2007;356(24):2457-71
79. Engelhard P. Correction options for lipoatrophy in HIV-infected patients. AIDS Patient Care STDS 2006;20(3):151-60
80. Guaraldi G, Orlando G, De Fazio D, et al. Comparison of three different interventions for the correction of HIV-associated facial lipoatrophy: a prospective study. Antivir Ther 2005;10(6):753-9
81. Guaraldi G, De Fazio D, Orlando G, et al. Facial lipohypertrophy in HIV-infected subjects who underwent autologous fat tissue transplantation. Clin Infect Dis 2005;40(2):e13-e15
82. Mori A, Lo Rg, Agostini T, et al. Treatment of human immunodeficiency virus-associated facial lipoatrophy with lipofilling and submalar silicone implants. J Plast Reconstr Aesthet Surg 2006;59(11):1209-16
83. Ahn MS. Calcium hydroxylapatite: Radiesse. Facial Plast Surg Clin North Am 2007;15(1):85-90
84. Silvers SL, Eviatar JA, Echavez MI, Pappas AL. Prospective, open-label, 18-month trial of calcium hydroxylapatite (Radiesse) for facial soft-tissue augmentation in patients with human immunodeficiency virus-associated lipoatrophy: one-year durability. Plast Reconstr Surg 2006;118(3 Suppl):S34-S45
85. Lam SM, Azizzadeh B, Graivier M. Injectable poly L-lactic acid (Sculptra): technical considerations in soft-tissue contouring. Plast Reconstr Surg 2006;118(3 Suppl):S55-S63
86. Valantin MA, Aubron-Olivier C, Ghosn J, et al. Polylactic add implants (New-Fill) to correct facial lipoatrophy in HIV-infected patients: results of the open-label study VEGA. AIDS 2003;17(17):2471-7
87. Barton SE, Engelhard P, Conant M. Poly-L-lactic acid for treating HIV-associated facial lipoatrophy: a review of the clinical studies. Int J STD AIDS 2006,17(7):429-35
88. Vleggaar D, Bauer U. Facial enhancement and the European experience with Sculptra (poly-L-lactic acid). J Drugs Dermatol 2004;3(5):542-7
89. Gooderham M, Solish N. Use of hyaluronic acid for soft tissue augmentation of HIV-associated facial lipodystrophy. Dermatol Surg 2005;31(1):104-8
90. Denton Ab, Tsaparas Y. Injectable hyaluronic acid for the correction of HIV-associated facial lipoatrophy. Otolaryngol Head Neck Surg 2007;136(4):563-7
91. Ritt MJ, Hillebrand-Haverkort ME, Ten Veen JH. Local treatment of facial lipodystrophy in patients receiving HIV protease inhibitor therapy. Acta Chir Plast 2001;43(2):54-6
92. Jones D. HIV facial lipoatrophy: causes and treatment options. Dermatol Surg 200531 (11 Pt 2):1519-29
93. Denton AB, Tsaparas Y. Injectable hyaluronic acid for the correction of HIV-associated facial lipoatrophy. Otolaryngol Head Neck Surg 2007;136(4):563-7
94. Driscoll SD, Meininger GE, Larcau MT, et al. Effects of exercise training and metformin on body composition and cardiovascular indices in HIV-infected patients. AIDS 2004;18(3):465-73
95. Martinez E, Domingo P, Ribera E, et al. Effects of metformin or gemfibrozil on the lipodystrophy of HIV-infected patients receiving protease inhibitors. Antivir Ther 2003;8(5):403-10
96. Hadigan C, Corcoran C, Basgoz N, et al. Metformin in the treatment of HIV lipodystrophy syndrome: A randomized controlled trial. JAMA 2000;284(4):472-7
97. Saint-Marc T, Touraine JL. Effects of metformin on insulon resistance and central adiposity in patients receiving effective protease inhibitor therapy. AIDS 1999;13(8):1000-2
98. Burgess E, Wanke C. Use of recombinant human growth hormone in HIV-associated lipodystrophy. Curr Opin Infect Dis 2005;18(1):17-24
99. Luzi L, Meneghini E, Oggionni S, et al. GH treatment reduces trunkal adiposity in HIV-infected patients with lipodystrophy. a randomized placebo-controlled study. Eur J Endocrinol 2005;153(6):781-9
100. Torres RA, Unger KW, Cadman JA, Kassous JY. Recombinant human growth hormone improves truncal adiposity and 'buffalo humps' in HIV-positive patients on HAART. AIDS 1999;13(17):2479-81
101. Yin MT, Gicsby MJ. Recombinant human growth hormone therapy in HIV-associated wasting and visceral adiposity. Expert Rev Anti Infect Ther 2005;3(5):727-38
102. Wanke C, Gerrior J, Kantaros J, Coakley E, Albrecht M. Recombinant human growth hormone improves the fat redistribution syndrome (lipodystrophy) in patients with HIV. AIDS 1999;13(15):2099-103
103. Moyle GJ, Daar ES, Gertner JM, et al. Growth hormone improves lean body mass, physical performance, and quality of life in subjects with HIV-associated weight loss or wasting on highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2004;35(4):367-75
104. Grunfeld C, Thompson M, Brown SJ, et al. Recombinant human growth hormone to treat HIV-associated adipose redistribution syndrome: 12-week induction and 24-week maintenance therapy J Acquir Immune Defic Syndr 2007;45(3):286-97
105. Falutz J, Allas S, Kotler D, et al. A placebo-oontrolled, dose-ranging study of a growth hormone releasing factor in HIV-infected patients with abdominal fat accumulation. AIDS 2005;19(12):1279-87
106. Koutkia P, Canavan B, Breu J, Grinspoon S. Growth hormone (GH) responses to GH-releasing hormone-arginine testing in human immunodeficiency virus lipodystrophy. J Clin Endocrinol Metab 2005;90(1):32-8
107. Koutkia P, Eaton K, You SM, et al. Growth hormone secretion among HIV infected patients: effects of gender, race and fat distribution. AIDS 2006;20(6):855-62
108. Kourkia P, Canavan B, Breu J, et al. Growth hormone-relcasing hormone in HIV-infected men with lipodystrophy: a randomized controlled trial. JAMA 2004;292(2):210-18
109. Fitch KV, Anderson EJ, Hubbard JL, et al. Effects of a lifestyle modification program in HIV-infected patients with the metabolic syndrome. AIDS 2006;20(14):1843-50
110. Thoni GJ, Fedou C, Brun JF, et al. Reduction of fat accumulation and lipid disorders by individualized light aerobic training in human immunodeficiency virus infected patients with lipodystrophy and/or dyslipidemia. Diabetes Metab 2002,28(5):397-404
111. Yarasheki KE, Tebas P, Stanerson B, et al. Resistance exercise training reduces hypertriglyceridemia in HIV-infected men treated with antiviral therapy. J Appl Physiol 2001;90(1):133-8
112. Roubenoff R, Weiss L, Mcdermott A, et al. A pilot study of exercise training to reduce trunk fat in adults with HIV-associated fat redistribution. AIDS 1999;13(11):1373-5
113. Jones SP, Doran DA. Leatt PB, et al. Short-term exercise training improves body composition and hyperlipidaemia in HIV-positive individuals with lipodystrophy. AIDS 2001;15(15):2049-51
114. Robinson FP, Quinn LT, Rimmer JH. Effects of high-intensity endurance and resistance exercise on HIV metabolic abnormalities: a pilot study. Biol Res Nurs 2007;8(3):177-85
115. Martinez E, Arnaiz JA, Podzamczer D, et al. Substitution of nevirapine, efarvirenz, or abacavir for protease inhibitors in patients with human immunodeficiency virus infection. N Engl J Med 2003;349(11):1036-46
116. Lafeuillade A, Clumeck N, Mallolas J, et al. Comparison of metabolic abnormalities and clinical lipodystrophy 48 weeks after switching from HAART to Trizivir versus continued HAART: the Trizal study. HIV Clin Trials 2003;4(1):37-43
117. Drechsler H, Powderly WG. Switching effective antiretroviral therapy: a review. Clin Infect Dis 2002;35(10):1219-30
118. Mobius U, Lubach-Ruitman M, Castro-Frenzel B, et al. Switching to atazanavir improves metabolic disorders in antiretroviral-experienced patients with severe hyperlipidemia J Acquir Immune Defic Syndr 2005;39(2):174-80
119. Calza L, Manfredi R, Chiodo F. Statins and fibrates for the treatment of hyperlipidaemia in HIV-infected patients receiving HAART. AIDS 2003;17(6):851-9
120. Visnegarwala F, Maldonado M, Sajja P, et al. Lipid lowering effects of statins and fibrates in the management of HIV dyslipidemias associated with antiretroviral therapy in HIV clinical practice. J Infect 2004;49(4):283-90
121. Doser N, Kubli S, Telenti A. et al. Efficacy and safety of fluvastatin in hyperlidemic protease inhibitor-treated HIV-infected patients. AIDS 2002;16(14):1982-3
122. Aberg JA, Zackin RA, Brobst SW, et al. A randomized trial of the efficacy and safety of fenofibrate versus pravastatin in HIV-infected subjects with lipid abnormalities: AIDS Clinical Trials Group Study 5087. AIDS Res Hum Retroviruses 2005;21(9):757-67
123. Calza L, Manfredi R, Colangeli V, et al. Substitution of nevirapine or efavirenz for protease inhibitor versus lipid-lowering therapy for the management of dyslipidaemia. AIDS 2005;19(10):1051-8
124. Schambelan M, Benson CA, Carr A, et al. Management of metabolic complications associated with antiretroviral therapy for HIV-1 infection: recommendations of an International AIDS Society-USA panel. J Acquir Immune Defic Syndr 2002;31(3):257-75
125. Bonnet F, Balestre E, Thiebaut R, et al. Fibrates or statin and lipid plasma levels in 245 patients treated with highly active antiretroviral therapy Aquitaine Cohort, France, 1999-2001. HIV Med 2004;5(3):133-9
126. Rao A, D'amico S, Balasubramanyam A, Maldonado M. Fenolibrate is effective in treating hypertriglyceridermia associated with HIV lipodystrophy. Am J Med Sci 2004;327(6):315-18
127. Gerber MT, Mondy KE, Yarasheski KE, et al. Niacin in HIV-infected individuals with hyperlipidermia receiving potent antiretroviral therapy. Clin Infect Dis 2004;39(3):419-25