July / August #93 : Neg (-) But (+) For Lipo - by Greg Lugliani

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Publisher's Letter


Sex Ed’s Rubber Rubout

PREPing For Sex

On Me, Not Inn Me

Out Of Data


I Go Shout Plenty

Class Pictures


Time Out

Bill Me Later


Natal Attraction


Wall Of Controversy

Shades Of Gray

Give Me Fever

Bad Meds

Hot And Bothered

Pass The Scalpel—And The Bucks

Northern Exposure

Cell Low, Cell High

Pillow Talk

Neg (-) But (+) For Lipo

A New Gay Plague?

Hard Workin’ Beans

Viread, Once A Wonder Drug

It's His Party

Out Of Sight

The Truth About Cats And Dogs (& A Horse And A Bird)

Getting’ Hot In Here

The Big Bang Theory

Walk This Way

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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July / August 2003

Neg (-) But (+) For Lipo

by Greg Lugliani

The root of HIV-related lipodystrophy—abnormal fat redistribution—is a big fat mystery. Now those who say, “It’s the meds, stupid,” can cite the April 2003 AIDS report that an HIV-negative man, after risky intimacies, took post-exposure prophylaxis (PEP)—and came down (or blew up) with lipo, though not with HIV.

Dusseldorf HIV pro Stefan Mauss, MD, gave the 32 year old two three-week courses of HIV meds—3TC (Epivir), d4T (Zerit) and efavirenz (Sustiva)—to prevent HIV. Soon after popping his last PEP, the man’s midsection swelled. Computerized tomography (CT) confirmed that visceral (deep under the skin) and subcutaneous (just under the skin) fat had grown, but lipid and glucose levels—often out of whack with lipo—were normal.
Four months later, Herr Patient was still bellied up—and still neg.  “This case [a first] may be a limited proof of principle” that meds, not HIV itself, cause the dread disorder, Mauss said.

Some call the drugs-vs.-virus debate stale as yesterday’s bratwurst. “Most of us already think protease inhibitors and d4T are involved,” says New York City clinician Howard Grossman, MD.  

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