• Poster 13: Prevalence of Metabolic Complications in a Large Diverse Cohort of HIV-Infected Persons (Authored by W.M. El-Sadr, G. Collins, S. Raghavan, C. Rappoport, C. Gibert, A. Carr, And G. Bartsch. Community Programs For Clin. Res. On AIDS -- CPCRA)
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• Poster 18: Fat Distribution and Retinoid-like Symptoms are Infrequent in NRTI-Experienced Subjects Treated with Amprenavir (Authored by A. Fetter, P. Nacci, J. Lenhard, A. White, G. Pagano, S. Dhamu, And M.D. Rogers. Glaxo Wellcome Res. & Development, Greenford, UK; and Glaxo Wellcome Res. & Development, Res. Triangle Park, NC)
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Poster 13: Prevalence of Metabolic Complications in a Large Diverse Cohort of HIV-Infected Persons

The authors reviewed the presence of lipodystrophy (LD) and metabolic abnormalities in participants in five CPCRA studies, totaling 1,640 patients including over 500 patients who had not received antiretroviral therapy (ART). The incidence of diabetes mellitus, coronary disease or stroke was not different in the untreated or treated patients. However, body habitus changes were reported only in treated patients (5.3%). With further statistical analysis they found an association between increasing age and the development of diabetes, coronary disease, stroke and body habitus changes. This study is important in showing that there are likely different and multiple explanations for these abnormalities. Though ART clearly has an effect, so does aging. The big question of whether HIV infection accelerates the metabolic and clinical complications associated with aging itself remains unanswered.

Poster 18: Fat Distribution and Retinoid-like Symptoms are Infrequent in NRTI-Experienced Subjects Treated with Amprenavir

Fetter and colleagues from Glaxo-Wellcome reported that fat distribution and retinoid-like symptoms were infrequent in NRTI-experienced patients receiving amprenavir. So what does this mean? Retinoid-like symptoms have been associated with indinavir because of an association of IDV and retinoic acid metabolism. These symptoms include dry skin, xerostomia (dry mucous membranes), as well as hair and nail problems. In this study, close to 500 patients were randomized to receive either APV or IDV with background nucleosides. Abnormal fat distribution and retinoid-like symptoms were reported more often in the IDV recipients. We have seen reports that APV seems to be less likely than other PIs to produce the manifestations of lipodystrophy. This study supports this conclusion.