HIV Treatments Make Some Patients Look ‘Truly Ghoulish’
Lipodystrophy is a "truly ghoulish complicatio[n]" of
antiretroviral therapy that "slowly remodel[s] the body, turning people into weirdly living visions of the exact fate they are taking the drugs to elude," Dr. Abigail Zuger says in a New York Times health section commentary. The condition breaks down the normal processing and storage of fat, leaving patients with thin arms and legs but a bloated torso. Oddly, some of the healthiest patients are the ones most severely affected by lipodystrophy. "Of all the mysteries of AIDS, [lipodystrophy] is proving one of the most difficult to crack," Zuger says, noting that while some patients suffer from the fat redistribution, others are spared the condition. Worse than the cosmetic effects, in some cases the body reacts to the drugs in a way that causes "diabetes, high cholesterol, heart and vascular disease and fatty, fragile bones." All 15 AIDS drugs available bear a risk of lipodystrophy, and there is no effective treatment for the condition. As antiretroviral drugs prolong the lives of HIV/AIDS patients, Zuger writes, it is unclear which chronic diseases and weight gain conditions are the consequences of aging or those resulting from the medication. A study presented at a February AIDS conference in Chicago found that an "alarming" 63% of people taking antiretroviral drugs developed lipodystrophy, but "according to the definition of the syndrome researchers were using, 33% of ordinary HIV-negative controls got it too." Because of the awkward effects of AIDS drugs, as well as other side effects such as nausea, diarrhea, and skin rashes, many activists who once strongly advocated for faster FDA approval of anti-HIV medication are now beginning to lobby to get off the drugs for a period, "coasting on the accrued benefits in hopes of avoiding the worst of their toxicity" (Zuger, New York Times, 4/3).
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