How to decrease HIV related belly fat accumulation

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Nelson Vergel

Founder, ExcelMale.com
My latest HIV lecture:


Nelson Vergel, founder of PoWeRUSA.org, covers the following topics:

  1. Weight Gain in the New HIV Era- Review of Studies
  2. Preventing Heart Disease
  3. Reducing Visceral Fat
  4. Healthy Nutrition Tips
  5. Exercise Tips
  6. Weight Loss Medications
  7. Hormone Balance
  8. Sleep- The Pillar of Health
  9. Resources

Weight Gain in HIV: Then and Now:

1996- 2006:


Weight gain was characterized by accumulation in the visceral and cervical area (lipohypertrophy) in the boosted protease plus thymidine nucleoside era (Crixivan, Kaletra, AZT, Zerit) along with fat loss under the skin (lipoatrophy). Lipoatrophy decreased after Zerit and AZT were no longer recommended in the U.S. in 2004. ARV-related mitochondrial toxicity plus insulin resistance were factors identified in body changes along with inflammatory cytokines. Some genetic factors were also identified but not investigated in detail. The term “lipodystrophy”” was later changed to “return-to-health” syndrome as strong immune reconstitution was identified as a major factor.

2006-2020:

The only treatment approved for the treatment of increased abdominal fat is Egrifta SR.

We hoped that integrase inhibitors would not cause weight gain since they are not associated with mitochondrial toxicity or insulin resistance. They were later found to cause greater weight gain than protease inhibitors in naïve patients and those switching to integrase inhibitors. This trend is most pronounced in women, blacks, and persons ≥ 60 yrs. of age.

We have learned that all antiretrovirals (ARVs) can cause weight gain and that patient-related factors that may worsen their effect. Fortunately, disfiguring lipodystrophy is rare in patients not exposed to AZT, Zerit and older ARVs. However, many long-term survivors are still dealing with these body changes.
 

Attachments

  • Women Aging Healthy 2020 handout.pdf
    4.8 MB · Views: 75
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