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The exact mechanism of HIV-associated lipodystrophy is not fully elucidated. There is evidence indicating both that it can be caused by anti-retroviral medications and that it can be caused by HIV infection in the absence of anti-retroviral medication.
Lipodystrophy can be a possible side effect of certain antiretroviral drugs. Lipoatrophy is most commonly seen in patients treated with thymidine analogues and other older HIV drug treatments such as the nucleoside reverse transcriptase inhibitors [NRTIs] [9] like zidovudine (AZT) and stavudine (d4T). [10]
HIV is a major cause of cardiomyopathy (problems with the heart muscle that reduce the efficiency with which the heart pumps blood). The most common type of HIV induced cardiomyopathy is dilated cardiomyopathy also known as eccentric ventricular hypertrophy which leads to impaired contraction of the ventricles due to volume overload.
Commonly prescribed medications for HIV, such as sulfonamides, anticonvulsants, antibacterials, antifungals, antimycobacterials, and, most notably, antiretrovirals, have an increased incidence of adverse cutaneous drug reactions in HIV-positive individuals, and even greater escalation of incidence in people with advanced disease progression in the form of AIDS. [4]
Cosmetic concerns may cause patients to refuse or stop treatment. If severe enough, the fat accumulation may result in sleep apnea or other sleep disorders, migraines, decreased range of motion, discomfort due to pressure on internal organs, and general loss of condition. Fat loss may result in pain in the buttocks when seated.
Schematic description of the mechanism of the four classes of available antiretroviral drugs against HIV. There are six classes of drugs, which are usually used in combination, to treat HIV infection. Antiretroviral (ARV) drugs are broadly classified by the phase of the retrovirus life-cycle that the drug inhibits. Typical combinations include ...
Insulin resistance, or low insulin sensitivity, happens when cells throughout the body don’t respond properly to the hormone insulin, especially cells in muscles, fat and the liver. Insulin is a ...
Atazanavir was the first PI approved for once-daily dosing. It appears to be less likely to cause lipodystrophy and elevated cholesterol as side effects. It may also not be cross-resistant with other PIs. Fosamprenavir: Lexiva, Telzir: GlaxoSmithKline — October 20, 2003: A prodrug of amprenavir. The human body metabolizes fosamprenavir in ...