Complications and side effects:
Among the biochemical changes that characterize the lipodystrophy syndrome include an increase in lipid levels in the blood. This includes an increase in triglyceride levels and LDL-cholesterol (“bad") and a decrease in the cholesterol-HDL (“good"). This combination may increase the risk of cardiovascular disease and diabetes.

Changes food (more fibre, fruits and vegetables and less animal fat), the adoption of an exercise program and stopping smoking are a good start for those with the long term is to lower their lipid levels. However, it is not always easy to adopt good habits and it may take time to arrive, so some doctors find it useful to prescribe treatments designed to reduce lipid levels. There are two main types of lipid - lowering drugs or fibrates (ciprofibrate, fenofibrate) and statins (atorvastatin, rosuvastatin, simvastatin).

Statins and mitochondria
Some researchers fear that statins can affect the parts of cells responsible for energy production, namely the mitochondria (Mt). In people living with HIV / AIDS, it is possible that the Mt is already strained by antiretrovirals and HIV protein called Viral Protein R (Vpr). To learn more about the effect of statins, the researchers Primagen company (specializing in the development and marketing of molecular tests), in Amsterdam, have experimented with two groups of PLWHA. The first group consisted of seven subjects who were examined before and after treatment with simvastatin at 40 mg / day. The six subjects in the second group received ciprofibrate 100 mg / day. All participants had cholesterol and / or triglycerides above normal and were receiving lipid - lowering treatment for two months.

The researchers found that fibrates had no effect on the DNA of white blood cells Mt. However, the rate of DNA has increased significantly Mt. The researchers attribute this change to the fact that statins inhibit not only the natural production of cholesterol but also the antioxidant co-enzyme Q10 (Co-Q10). This plays an important role in energy production in the Mt and also protects them against damage. To compensate for the lower rate of co-Q10, researchers argue that the Mt tried to produce other proteins, hence increasing the rate of DNA.

In the context of laboratory experiments, researchers have grown cells in the presence of anti-HIV drugs dideoxyinosine (ddI) and dideoxydidehydeothymidine (d4T) and simvastatin and ciprofibrate. They found that the combination of nucleoside analogues and statins has caused more toxicity than either class of drugs alone. Studies of longer duration are needed to evaluate the safety of statins in patients with combination antiretroviral therapy.


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