Australia: AIDS Drugs Trigger Inflammation Linked to Diabetes, Study Says

Researchers in Australia say a new study may help explain why people taking certain AIDS drugs are more likely to develop diabetes and heart disease. Nucleoside reverse transcriptase inhibitors (NRTIs) like Gilead Science's Truvada trigger inflammation that can lead to the metabolic complications, said Katherine Samaras, head of the diabetes and obesity clinical research group at Sydney's Garavan Institute.

Samaras and colleagues at Sydney's St. Vincent's Hospital and the Royal Perth Hospital compared the body composition and metabolic response of 20 HIV-positive men on antiretroviral therapy with 26 HIV-negative, obese men suffering insulin resistance, a precursor to diabetes.

"What is novel in this paper is how much more inflammation there is with treated HIV infection, and that there is more inflammation that circulates in the blood stream than what we see in very overweight people," said Samaras.

"People being treated for HIV tend to lose fat on their arms, legs, face, and buttocks and gain it around their abdomen," said Samaras. "This redistribution of fat is termed 'lipodystrophy,' and those patients with the condition have a cardiac and metabolic risk profile worse than being very obese."

"For us, it was a surprise because these people are usually quite healthy in their body size, they're not obese," Samaras noted.

According to Samaras, the inflammatory response was primarily linked to NRTIs, a class of medicines first used to treat HIV more than two decades ago. It is difficult to identify side effects caused by specific medications because patients commonly take a cocktail of drugs to prevent HIV from developing resistance, she said.

The study, "Proinflammatory Markers, Insulin Sensitivity, and Cardiometabolic Risk Factors in Treated HIV Infection," was published in the journal Obesity (2008;doi:10.1038/oby.2008.500).