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HIV's Latest Symptom: Abdominal Obesity


Not only does HIV slowly wear down the immune system — now it also makes you fat.

HIV can lead to opportunistic infections, AIDS, or worse, obesity. Since 2013, the American Medical Association now defines obesity as a disease. Danish researchers have begun to uncover the relationship between the side effects from HIV drug regimens and a stubborn waistline.

According to a recent study published in Clinical Infectious Diseases, people living with HIV are at increased risk for abdominal obesity, hypertriglyceridemia, and elevated low-density lipoprotein (LDL) cholesterol. They didn’t find, however, an increased risk for hypertension in HIV-positive people.

Researchers observed almost 1100 people living with HIV from a Copenhagen Comorbidity in HIV Infection (COCOMO) study using 12,161 uninfected sex and age-matched controls from a Copenhagen General Population Study.

Several factors were considered, including smoking, physical activity, medication, and educational level. Waist and hip measurements, blood pressure, body mass index (BMI), blood levels of triglycerides, LDL-C, total cholesterol, glucose, and HbA1c were all closely monitored. People living with HIV were observed with a lower BMI than the control participants, yet they had a higher incidence of abdominal obesity (63.5%) versus a lower prevalence (59.8%) that was observed in the control patients.

People living with HIV also were observed with a higher prevalence of hypertriglyceridemia than control participants, as well as a lower prevalence of hypertension.

It can all be explained by HIV drug regimens.

Earlier generations of antiretroviral treatments (ART) for HIV, researchers have explained, resulted in a high incidence of fat redistribution syndrome. You might remember additional drugs being marketing to HIV-positive consumers such as Egrifta. These are intended to augment the effects of HIV drugs they are already taking.  “EGRIFTA® causes the pituitary gland to release growth hormone, which decreases abdominal fat,” the drug’s makers claim on its website. Egrifta is injectable, which goes to show how desperate HIV-positive men and women are, when it comes to unwanted body fat around the middle area.

The pituitary gland controls the growth hormone, which in turn, dramatically affects the fat distribution in the body. People who have pituitary gland disorders can have uncontrollable weight gains or losses.

Things got better after the introduction of improved combination ART (cART) with only minor metabolic  side effects, due to excess hormones.

According to the new research, already-normal fat redistribution that we see in aging adults is amplified by HIV drug regimens, resulting in an synergistic effect that is both parallel and interconnected.

Doctors have known about these metabolic side effects for some time now.

About a year ago, researchers from 12 universities from across the globe released a consensus statement about obesity and lipohypertrophy among people living with HIV. Lipohypertrophy causes a “buffalo hump” or unwanted fatty deposits in strange areas of the body. This, in part, contributes to the noticeable effects of HIV and HIV/AIDS medicine in people, which others claim they can see with the naked eye.

“Renewed attention by the medical community [toward] the abdominal obesity phenotype, and innovative interventions targeting this condition are therefore needed in order to reduce the risk [for] cardiovascular disease in people living with HIV,” the researchers concluded.

Beyond vanity and self-esteem, a thicker waistline puts people living with HIV at a higher risk for cardiovascular disease — and that’s already a problem for us. Here’s why it should concern you: Cardiovascular disease, researchers say, is the principal contributor to non-AIDS mortality and morbidity among people living with HIV.

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Benjamin M. Adams