The role of ARVs in lipodystrophy

  • At first, people with HIV and doctors thought the changes were caused by protease inhibitors. In fact, the changes have also been seen in a number of people who have never taken protease inhibitors.

  • Many different patterns of body fat changes are being seen, so it is likely that different drugs cause different patterns of changes.

  • Generally, the protease inhibitors have been linked to fat accumulation while the thymidine analogue NRTIs (d4T and, to a lesser extent, AZT) have been linked to fat loss.

  • Most studies suggest that d4T (stavudine or Zerit) is a major cause of fat loss. For this reason, all treatment guidelines now recommend that d4T should not be used for first-line treatment if other options exist.

  • Ritonavir (Norvir) seems to be the drug most strongly linked to fat gain when it was used at full dose (600mg twice daily); however, this dosage is no longer used in practice.

    • Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

    Together, we can make it happen

    We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

    Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

    The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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