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Cases of lipodystrophy have been reported among people taking any of the currently licensed protease inhibitors. In some studies the development of the signs of lipodystrophy during protease inhibitor therapy was as high as 64%.
The results of an Australian trial of combination therapy with ritonavir and saquinavir showed, 30% of participants had developed lipodystrophy after 48 weeks treatment, 68% had elevated cholesterol, and 85% had elevated triglycerides.
Many HIV patients being treated with protease inhibitors experience increases in blood cholesterol and triglycerides. It is yet unknown if these increases are related to lipodystrophy or are an entirely separate side-effect, nor is it known what the longer term implications may be. Since high levels of blood cholesterol and triglycerides maintained over long periods may contribute to heart disease.
In a Canadian trial of ritonavir/saquinavir, 11% of patients saw triglyceride levels increase three- to four-fold during treatment. A number of these patients were treated with drugs designed to reduce the levels of lipids in the blood. Gemfibrozil (Lopid) and clofibrate significantly reduced these lipid levels by more than 50% in four out of six cases.
Some physicians conclude that while lipodystrophy is cosmetically undesirable and may cause significant psychological distress, it remains to be seen whether it is a symptom of a serious underlying condition.
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