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Lipodystrophy and WastingLipodystrophy and Wasting
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Oct 12, 2003

Hi Dr. Moyle

Talk about TNF please. If one uses inhibitors to reduce the amount of TNF in the blood and tissues, won't HIV or HIV-related problems worsen? Isn't the TNF keeping some part of the HIV at bay (even though, of course, it produces a very undesireable wasting syndrome)?

Response from Dr. Moyle

There have been several studies that have suggested that tumour necrosis factor (TNF) may be associated with weight loss and lipoatrophy. Therefore there is some interest in drugs which may suppress TNF production. However, the drugs which do this such as pentoxyphiline and thalidomide are associated with toxicity is of their own and are not well-suited for long-term administration. And the TNF drugs which are now approve the use in rheumatoid arthritis have not been tried in the HIV setting but are very expensive and at least in some studies there were suggestions that there may be an increased risk of tuberculosis in some people taking these medication. It is not clear is TNF itself plays a role in the immune response against HIV.

I have this gives you a starting point. It may be worthwhile searching the medical literature on Medscape, or The Body to investigate further.

Best wishes

Graeme Moyle

Do all patients on treatment develop butt wasting/lypodystrophy?

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