Drug Helps Ease Fat Disorder in HIV Patients

By E.J. Mundell
HealthDay Reporter
Thursday, December 6, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

WEDNESDAY, Dec. 5 (HealthDay News) -- An investigational drug may be the first safe, reliable means of easing a disorder that leads to unsightly "humps" of body fat and boosts the heart risks of HIV patients.

People taking the drug tesamorelin for 26 weeks showed a 15 percent decline in dangerous visceral fat accumulating around their organs, as well as an improvement in related heart risk factors. They also reported psychological gains in terms of body image, said researchers reporting in the Dec. 6 issue of the New England Journal of Medicine.

While the long-term safety of tesamorelin remains unanswered, "we are very hopeful about this -- this could be one of the first major therapies in this regard," said the study's senior author, Dr. Steven Grinspoon, an associate professor of medicine at Harvard Medical School.

The study was funded by Theratechnologies, the Canadian company that is developing the drug.

Abnormalities in metabolism and fat deposits ("lipodystrophy") are common in people who take powerful antiretroviral drugs to help suppress HIV. "It's fairly prevalent in over half of the patients," said Grinspoon, who is also director of the Program in Nutritional Metabolism at Massachusetts General Hospital.

For reasons that remain unclear, HIV drug therapy often reduces normal fat levels in the arms and the legs while boosting it in other areas, including unsightly "humps" at the shoulder. The drugs can also shift fat deposition to deep in the abdomen, around the organs. This visceral fat is strongly associated with an increase in blood levels of cholesterol and triglycerides, as well as insulin resistance, which can lead to diabetes.

"All of that conspires to increase the risk of vascular disease," explained Dr. Marc Blackman, associate chief of staff for research and development at the VA Medical Center in Washington, D.C.

So far, no intervention has really helped correct this disorder, said Blackman, who also authored an accompanying commentary in the journal.

"Exercise, diet, diabetes or cholesterol drugs -- none of them has been shown to be terribly effective," he said.