Treatment Update from Seattle: part one
Last issue PN reported the main treatment news stories from the 9th Retrovirus
page 1 of 3
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There has been concern that rises in blood fats - cholesterol and triglycerides
- attendant on taking HIV drugs could be creating a secondary epidemic
of heart problems, and even that, for patients with risk factors for heart
disease (male, middle-aged, smoker, stress), the health risk of HIV treatment
at anything other than very low CD4 counts could outweigh the benefit.
And yet a big study at the 9th Retrovirus Conference reported no increased
risk of heart problems after HIV combo therapy started in 1996 (see PN
April,
for details).
But the problem with such studies is that HIV treatment hasn't been
around long enough for us to even guess at its truly long-term effects.
After all, if you smoke, you won't usually start paying the price for
the first 10 -15 years.
However, one study provided some backup to the idea that the lipid rises
may not be of the type that causes heart disease. Germany's Stefan Mauss
analysed the cholesterol increases in 87 patients taking combination therapy,
of which 45 per cent had raised cholesterol.
The kind of cholesterol they had was crucial. Only 14 per cent had increases
in low-density cholesterol (LDL) - that's the 'bad' kind that sticks to
the lining of arteries.
Two-thirds, in contrast, had increases in very low-density cholesterol
