Zerit-related Lipoatrophy Is Reversible by Switching to Other NRTI

[Guest guest]

Zerit-related Lipoatrophy Is Reversible by Switching to Other NRTI

By Karla Gale

Lipoatrophy (fat loss) associated with Zerit (stavudine) treatment for HIV infection can be reversed by switching to another nucleoside reverse transcriptase inhibitor (NRTI), according to results of a study presented at the 41st Annual Meeting of the Infectious Diseases Society of America in San Diego.Moreover, reversal of the condition is due to reductions in mitochondrial toxicity and less adipocyte apoptosis, lead investigator Dr. Grace A. McComsey told Reuters Health.Dr. McComsey, of Case Western Reserve University in Cleveland, and her associates initiated a clinical trial that included 16 subjects switched from stavudine to Ziagen (abacavir) or Retrovir (zidovudine) after significant fat wasting had taken place.By the end of the 48-week study, trunk fat had increased by a median of 23% as quantified by dual energy X-ray absorptiometry and computed tomography. Arm and leg subcutaneous fat increased by 25% and 15%, respectively."It was impressive to see that much change, because lipoatrophy is a condition that develops over years of treatment," Dr. McComsey told Reuters Health. "So reversal of the condition after only a year with no other intervention was amazing." She expects continued improvement over time."Cytokine dysregulation and mitochondrial toxicity are the two top contenders" for explaining the mechanisms responsible for lipoatrophy, Dr. McComsey noted. Therefore, her group examined the relationship between mitochondrial function, apoptosis, and cytokine expression in adipocytes, blood cells and muscle cells. At baseline, median mitochondrial DNA per fat cell was approximately one-fourth of that observed in 25 control subjects, whereas adipocyte apoptosis was approximately quadrupled. Both measures had partially normalized 48 weeks after stavudine discontinuation. Furthermore, these findings correlated well with those observed in muscle and blood, Dr. McComsey added. "Our results suggest that mitochondrial toxicity is not tissue specific." When the team measured mRNA levels for 12 different cytokines, they observed no significant differences over time. "Seeing significant mitochondrial improvement and clinical improvement with no change in cytokines tells us that although cytokine dysregulation may happen, it is independent of NRTIs effects on mitochondria," she concluded.

Vergel

Director, Program for Wellness Restoration (PoWeR)

An all volunteer non profit 501 © 3 organization.

Built to Survive at:

http://www.medibolics.com