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Elevated levels of interleukin-18—a cytokine that causes inflammation and tissue destruction—in HIV-positive people may be leading to lipodystrophy-related fat loss in the face and extremities, according to a study in the May 1 issue of The Journal of Acquired Immune Deficiency Syndromes.

Researchers studied 42 HIV-positive men at a Copenhagen clinic and discovered that IL-18 levels were significantly higher in the men experiencing lipodystrophy-related fat loss and somewhat elevated in those with a combination of fat loss and central fat gains. Men taking Zerit also were more prone to high IL-18 levels. IL-18 levels were lower in HIV-positive men not experiencing fat loss or gain but were still higher than in HIV-negative adults.

The researchers conclude that there is a significant link between inflammation caused by elevated IL-18 levels and antiretroviral-induced metabolic changes, particularly fat loss.