The recent expansion in the number and variety of therapeutic tools available to treat HIV has led to significant advances in treatment options. While advantageous to the patient, the profusion of treatment options requires the treating clinician to keep abreast of the adverse effects possible from the use of such an array of drug combinations. The current knowledge base is critical to managing the adverse effects of antiviral therapies and to achieving long-term treatment success.

While many adverse side effects have already been identified for a number of existing antiviral drugs, the effects of newer drugs and the events caused by novel drug combinations are still a matter of investigation. In addition, interactions between this larger array of drugs and the virus itself are not yet fully understood. It is thus imperative that leading investigators begin to marshal clinical knowledge and the latest research findings to further the understanding of adverse drug interactions induced by current and future treatment options.

In establishing the first workshop on this rapidly evolving topic the organizers hope to provide a forum for active discussion and leading edge information. Much of this first meeting will cover lipodystrophy, a topic currently under much discussion and investigation. The aims of this workshop are to provide a medium for participants to discover the results of the latest scientific developments and to establish a consensus definition for lipodystophy. The purpose of this workshop is to stimulate the effort to further extend and enhance knowledge of those involved in developing and managing the treatment of HIV and AIDS.

Following are selected conference summaries of abstracts reported exclusively for The Body by Abhimanyu Garg, M.D., Associate Program Director, General Clinical Research Center, The Center for Human Nutrition and Associate Professor of Internal Medicine, the University of Texas Southwestern Medical Center at Dallas, and Joep Lange, M.D., Professor of Internal Medicine, Academic Medical Centre, University of Amsterdam, and Director, National AIDS Therapy Evaluation Centre, Netherlands.

Funding for this conference coverage at The Body is provided, in part, by an unrestricted educational grant by Agouron Pharmaceuticals, Inc. and Bristol-Myers Squibb Immunology.

Conference Summaries:

Sunday, June 27, 1999

• Session 3: Wasting
  • Abstract No. 6: Body Composition Before and After HAART
    Summary by Abhimanyu Garg, M.D.

• Session 4: Related Syndromes
  • Abstract No. 8: Genetic and Acquired Lipodystrophy Syndromes
    Summary by Abhimanyu Garg, M.D.
  • Abstract No. 9: Mitochondrial Toxicity of Nucleosides
    Summary by Abhimanyu Garg, M.D.

• Session 5: Recent Cohort Studies
  • Abstract No. 4: Sydney Cohort
    Summary by Abhimanyu Garg, M.D.
  • Abstracts No. 10 and No. 11: Description of Lipodystrophy in the HIV Outpatient Study (HOPS)
    Summary by Abhimanyu Garg, M.D.
  • Abstract No. 11: A Syndrome of Lipodystrophy (LD), Lactic Acidemia and Liver Function Associated with HIV Nucleoside Analogue Reverse Transcriptase Inhibitor Therapy: Contribution to PI-Related Syndrome
    Summary by Joep Lange, M.D.
  • Abstract No. 18: Case Report of Lipodystrophy Observations in Patients Naïve of Protease Inhibitor (PI) Treatment, Aquitaine Cohort, 1999
    Summary by Joep Lange, M.D.
  • Abstract No. 19: Protease Inhibitors (PIs) and Nucleoside Analogue Reverse Transcriptase Inhibitors (NRTIs) Interact to Cause Subcutaneous Fat Wasting in Patients with HIV Infection
    Summary by Joep Lange, M.D.
  • Abstract No. 20: Incidence of Fat Tissue Abnormalities in Protease Inhibitor-Naïve Patients Treated with NRTI Combinations
    Summary by Joep Lange, M.D.
  • Abstract No. 24 and No. 25: Reversability of Peripheral Fat Wasting (Lipoatrophy) on Stopping Stavudine (d4T) Therapy and
    Changes in Body Fat Distribution in 154 HIV-Infected Male Patients Treated with Combined Antiretroviral Therapy
    Summary by Joep Lange, M.D.
  • Abstract No. 26: Lipodystrophic Syndromes in a Cohort of HIV-1 Infected Patients Receiving HAART with a Protease Inhibitor (PI)
    Summary by Joep Lange, M.D.
  • Abstract No. 30: Incidence of Lipodystrophy on START (Selection of Thymidine Analog Regimen Therapy) Studies
    Summary by Joep Lange, M.D.
  • Abstract No. 31: A Multicenter, Randomized, Open-Label, Comparative Trial of the Clinical, Immunological and Virological Benefit of Switching the PI Nevirapine in HAART-Experienced Patients Suffering Lipodystrophy
    Summary by Joep Lange, M.D.
  • Abstract No. 40: One Year Effect of Switching from HIV-1 PIs to Nevirapine on Metabolic Abnormalities
    Summary by Joep Lange, M.D.
  • Abstract No. 58: Incidence of Metabolic Changes and Lipodystrophy in Two Trials Comparing Double Versus Triple Antiretroviral Therapy in Early HIV Disease
    Summary by Joep Lange, M.D.
  • Abstract No. 65: Stavudine (d4T) Use Is Not Associated with an Incremental Risk of Hyperlipidemia During Treatment with HIV-1 Protease Inhibitors (PIs)
    Summary by Joep Lange, M.D.
  • Abstract No. 67: Contribution of NRTI Combinations on Lipodystrophy and Impact of Therapy Switching
    Summary by Joep Lange, M.D.
  • Abstract No. 71: Clinical Factors Related to the Severity of Fat Redistribution in the HIV Outpatient Study (HOPS)
    Summary by Joep Lange, M.D.

Monday, June 28, 1999

• Reaching a Consensus -- Lipodystrophy Case Definition
  Summary by Abhimanyu Garg, M.D.