Hi. I am 49 y.o LM HIV+ diagnosed 6yrs ago. Undetectable. CD4: 625. Taking Viramune, Ziagen, Epivir. During the last two years I have developed a huge abdomen that does not go down despite diet/exercise. I also suffer from hyperlipidimia and HTN. I would like to get information about using Niacin to treat hypo accumulation of fat in the abdomen. Thxs,

The connection between niacin and intra-abdominal fat accumulation may lie in the improvement of HDL cholesterol according to a recent study at Kaiser Permanente in San Francisco (see the link below).

If that is the case, then methods of increasing HDL cholesterol (the good guys that are often low in HIV disease) may be of benefit.

Assuming that the huge belly is intra-abdominal fat accumulation it is worth checking out all the risk factors that you may be able to change without detriment. These include taking a look at your overall diet to head more toward the typical "diabetic diet" for insulin response control, closely evaluating and maybe even redesigning your exercise program, and other miscellaneous items like smoking, drinking, and such.

If you decide to use something like niacin, you will want to talk with your doctor about the non-flushing kind, any contraindications that may be present in your case, and a plan for monitoring your progress and for any adverse effects. While in many cases niacin looks like a nutrient, but you are looking at it in a pharmaceutical use and it should be attached to all the due caution any other medication is attached to.

Best wishes!

Niacin, HDL, and fat