PEOPLE being treated for HIV are at greater risk of contracting heart disease and type 2 diabetes than the morbidly obese because the most commonly prescribed medications cause fat on their arms, legs, face and buttocks to move to their stomachs, Sydney researchers have found.
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Excess weight around the waist increases a person's chances of developing cardiovascular and metabolic disorders, but doctors say newer classes of drugs, which do not cause fat redistribution, are too expensive for most people and have not been properly tested.
Researchers at the Garvan Institute in Darlinghurst found older style anti-retroviral drugs, still commonly used in Australia, gave many HIV patients the same level of heart disease as seen in obese people with sedentary lifestyles, the lead researcher, Katherine Samaras, said yesterday.
In her study, published in the journal Obesity , Associate Professor Samaras found that anti-retroviral drugs caused fat cells to create inflammatory molecules promoting disease.
"When fat cells are healthy they help maintain our metabolism, but if they become too large or are affected by drugs, such as HIV medications, they can produce a whole lot of chemicals linked to heart disease."
She said most people with HIV worked hard at staying healthy by going to the gym, maintaining a healthy weight and eating properly, so the side effects of HIV drugs were unfortunate.
"We also have the problem that the older drugs are off-patent now and very cheap so they are the frontline treatment in Third World countries." In the study, researchers examined magnetic resonance imaging and bone density scans measuring fat, muscle and bone mass of patients with HIV.
Blood tests were also taken to measure cholesterol, glucose and molecules involved in heart disease and diabetes, such as tumour necrosis factor-alpha, interleukin-6 and adiponectin.
"There are drugs on the market which do not have these side effects but they are not yet on the Pharmaceutical Benefits Scheme and are too expensive for most people," Associate Professor Samaras said.
"The primary concern is to optimise viral suppression, that is, reduce the virus load in the body, to minimise its effects."
But doctors had to ensure their patients maintained a strict diet, exercise and were regularly screened for diabetes, she said.
