Drugs to treat body fat loss

Studies are underway to see if any medicines can help prevent or reverse fat loss.

Creatine

Creatine is a dietary supplement often used by body builders. Some small preliminary studies have suggested that it can improve lean muscle mass in HIV-positive men. However, creatine can damage the kidneys, and people who are taking tenofovir and indivavir (Crixivan) should be particularly cautious about using creatine.

Uridine

Some studies suggest that uridine supplementation may be able to block the harmful effects of d4T and AZT while they are being taken and prevent and partially reverse fat loss. Uridine is available in a supplement called NucleomaxX. Unpleasant taste is its most widely reported side-effect and it interacts with ddI (Videx).

It can be bought from internet pharmacies but if you are thinking of taking it you should discuss its potential benefits and risks with your doctor first.

Statins

Pravastatin is widely used in HIV-positive people with increased lipids. There is some evidence that the use of pravastin can also help restore limb fat lost whilst taking d4T or AZT.

Treatment of facial wasting

Injections into the facial tissue can help restore a more normal facial appearance, but cannot regenerate facial fat cells.

Several forms of surgery have been used, with varying success, to repair body fat changes.

The use of polylactic acid, better known as New Fill™ has received a lot of attention.

Studies in the UK and abroad have shown that New Fill™ can reverse the appearance of facial wasting, leading to an improvement in people's self esteem and confidence.

New Fill™ is administered by a course of injections into the cheeks, normally spaced over six weeks. The injections encourage tissue growth and fill-out the sunken areas. Most people have three to five sets of injections.

It is uncertain how long the effects of New Fill™ last. So far, it seems that a single course of treatment will remain effective for at least two years in the majority of people. However, it may last longer in some people, and there have been reports of others needing treatment on an annual basis or even more frequently.

Treatment appears to be safe, with the most commonly reported side-effect being soreness and swelling in the area where the injections were administered.

Access to New Fill™ from the NHS is becoming more widely available, but it is not univeral. If you cannot get New Fill™ from the NHS, it is possible to obtain private treatment, cost varies from £800 – £1,200, depending on who you receive treatment from and how many treatments you need.

Other cosmetic treatments for facial wasting that are being examined include fat transfer, collagen injections, and hyaluronic acid.

Other injectable cosmetic treatments are becoming available; further information will be available from www.aidsmap.com or through NAM's treatment newsletter, AIDS Treatment Update (see insert within this booklet).