Terrible side effects of HIV drugs - CDC Daily Summary
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Amidst the great enthusiasm for developing countries drug access, the
problems of side effects in the US takers of HAART may deflate the
great enthusiasm... As reported in the CDC daily summary today, the
news below. Any African response to this real problem?
Nance Monot
mailto:nance@aids-bells.org
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"Humpty Dumpty vs Adonis: HIV Drugs Rewrite Script"
New York Times (04.03.01) Abigail Zuger, MD
"Of all the mysteries of AIDS, it is proving to be one of the most
difficult to crack." The mystery is lipodystrophy, a breakdown in the
normal ways the body processes and stores fat. A common side effect
of antiretroviral therapy, the condition causes "truly ghoulish com-
plications, slowly remodelling the body, turning people into weirdly
living visions of the exact fate they are taking the drugs to elude,"
Zuger said. A recent study found that 63 percent of patients taking
antiretrovirals developed lipodystrophy - yet 33 percent of the HIV-
negative control group experienced it as well. "Some people never get
it. In others, the body fat reacts to the medication right away,
causing not only cosmetic disaster... but also diabetes, high choles-
terol, heart and vascular disease and fatty, fragile bones.
None of the 15 AIDS drugs on the market seem entirely free of risk,"
Zuger said. With the advent of antiretroviral therapy, more AIDS pa-
tients are living longer. Yet this adds another wrinkle to the mys-
tery of lipodystrophy: Which effects are drug-related, and which are
simply the consequences of aging? Zuger described a patient who,
"back when he was really dying of AIDS... looked great." Yet now,
"restored to health with a concoction of HIV drugs, he looks mortally
ill." In AIDS clinics, Zuger said, "Never has the scene been stranger
than it is now, when the well often look quite sick and the sick
quite well, and no one can say for sure if the arrival of that small
gut of middle age is something to celebrate or not."
AIDS activists have lobbied for faster FDA approval of HIV drugs and
for making the drugs available to fight the epidemic in impoverished
nations. But now they are finding that "the complexities of these
drugs just do not fit on a placard anymore. In yet another strange
juxtaposition, nearly all the patients in the clinic - especially the
activists - are beginning to lobby to get off their drugs for awhile,
coasting on the accrued benefits in hopes of avoiding the worst of
their toxicity." Some patients on antiretrovirals develop lipodystro-
phy. Others, meanwhile, reap the drugs' positive benefits without the
disfiguring side effect - for now, anyway. "We're all waiting for the
other shoe to drop," Zuger concluded.
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