September #51 : Success Sucks - by Lark Lands and Edited by Bob Lederer

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Table of Contents

NYPD Blue

Born to be Wild

Locked Up in Limbo

Amazing Grace

Chai Guy

Catching Up With...Ruby Amagwula

Desperately Seeking Separatists

Hack vs. Hacker

LA Snuff Film

Dole Banana Peel

Say What

Feel Like a Nuttall

Caps Are On

What Dubya Stands For

The Disability Dis

Emotional Rescue

The End of L’Affaire

Picks

Undetectablah

Mother Inferior

Not for Adults Only

Get Over It

Lipo Handles

Topic of Cancer

Success Sucks

A Load of Fit

Thanks for the Complement

A Loaded Question

Message in a Bottle

Regarding Henry

S.O.S.

Contributors

Source of a Different Color

Mom's Recipe

Three Penny Opera

Letters to the Editor September 1999

Say What!

Woody Cheers on Rx Marijuana

Feel Like a Nuttall

Digest This

Obits

Detectablues

Not for Adults Only

Success Sucks

Facts Behind the Fix



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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September 1999

Success Sucks

by Lark Lands and Edited by Bob Lederer

Sky-hig levels of blood fats and reduced insulin sensitiity in some HIVers on HAART are being fought with drugs, but so far the results are a mixed bag. The fear that elevated cholesterol and triglycerides could lead to heart disease and pancreatitis ( a sometimes-fatal inflammation of the pancreas) makes the use of lipid-lowering (blood fat-reducing) compounds very appealing.

The problem is—you guessed it—interactions with protease inhibitors (PIs). David Zucman, MD, of L’Hopital Foch in Saresnes, France, reports that two months of atorvastatin (Lipitor) pills yielded drops in patients’ cholesterol from a baseline average of 336 milligrams/decaliter to 223 mg/dl, a significant reduction. But in those on a ritonavir (Norvir) and saquinavir (Fortovase) combo, blood levels of the drugs also significantly decreased. In such a short study, the long-term impact of reduced PI levels can’t be seen, but given the risk of inducing drug failure, be careful what you mix.

Meanwhile, treating insulin resistance—long known as one factor in  non-medication-related lipodystrophy—is now being tried for fighting the HAART-induced kind. In a six-month placebo-controlled trial, French researcher Thierry Saint-Marc, MD, found that when metformin (Glucophage), an insulin-sensitizing agent, was given to lipo sufferers, waist-to-hip ratios and abdominal fat declined. Although the improvements were only moderate and plateaued after two months, they remained for the duration. Since lipo symptoms usually only get worse over time, that’s a nice achievement for a drug. But don’t make plans to wash down those meds with the ol’ Dom Perignon—side effects can some-times include vitamin B-12 deficiency and lactic acid buildup, a potentially serious condition.




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