Reuters 23 February 2001

London -- Spanish AIDS researchers said on Friday prolonged use of anti-AIDS cocktails, and not a single drug, probably caused patients to develop unusual fat deposits on the upper back.

Lipodystrophy is a distressing side effect of the anti-AIDS cocktail. It causes so-called "buffalo humps" on the upper back and pot bellies, referred to as protease paunch.

The research by Dr Esteban Martinez and scientists at the Infectious Diseases Unit at the Hospital Clinic in Barcelona shows lipodystrophy increases with age, sex and use of a mixture of anti-AIDS drugs.

"Clinical research on lipodystrophy has usually rested on the idea that it was merely a complex adverse event related to individual antiretroviral agents or families of drugs," said Martinez, whose research is published in The Lancet medical journal.

"Our study suggests that the risk of lipodystrophy is mainly related to the total exposure to HAART (highly active antiretroviral therapy) and only to a lesser degree to specific antiretroviral drugs."

Martinez and his colleagues studied nearly 500 HIV patients who started HAART, consisting of two nucleoside reverse transcriptase inhibitors and at least one protease inhibitor, between October 1996 and September 1999.

Seventeen percent of the patients developed some type of lipodystrophy over 18 months. Women had a higher risk of getting the condition than men, and homosexuals and heterosexuals were also more prone to suffer from it than intravenous drug users.

"We have identified risk factors not related to antiretroviral therapy, such as age and sex, that have not received adequate attention until now. Future research should focus on these new risk factors," Martinez added.

An estimated 36.1 million people are living with HIV/AIDS, according to the latest figures released by the World Health Organisation and UNAIDS, the U.N. agency charged with battling the disease worldwide.

More than 25 million sufferers live in sub-Saharan Africa.

Anglo-American drugs group GlaxoSmithKline Plc (GSK.L) said on Thursday it had developed a novel AIDS vaccine and was planning human trial later this year.

Because of the high costs of anti-AIDS drugs and the growing number of sufferers in the developing world, a vaccine is regarded as the best way of controlling the epidemic.