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home > epc > autumn 2002 > fat redistribution in hiv patients - an opportunity for drug manufacturers?
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Fat Redistribution in HIV Patients - An Opportunity for Drug Manufacturers?

Fat redistribution, or lipodystrophy, is a complicated disorder of adipose (fat) tissue. There are two main classes of lipodystrophy: inherited lipodystrophies (genetically determined) and acquired lipodystrophies (for example HIV-associated). Historically, lipodystrophy was defined as the selective loss of fat from different regions of the body. This definition has changed, at least with regard to HIV-associated lipodystrophy. When being described in relation to HIV pathogenesis, lipodystrophy is now defined as 'selective fat loss or gain, with preserved body cell mass and weight'. In other words, the observation of abnormal peripheral subcutaneous fat wasting or fat accumulation in patients undergoing combination anti-retroviral therapy.

The global market for drug products to treat lipodystrophy is increasing in size. Epidemiology data are currently being collected for this syndrome, and an increasing amount of research is being conducted to determine the underlying causes of lipodystrophic disorders. Through awareness of this ongoing research, pharmaceutical companies can avoid both the potentially damaging impact of specific drug association and niche target patient groups with therapy combinations that either inhibit or limit the onset of this damaging disorder.

Figure 1 shows the historical development of lipodystrophy syndrome with respect to the introduction of monotherapy and combination therapy, with the consequent change in definition of the term lipodystrophy (revised from John et al 2001).

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By Dheeraj Khiytani, HIV Analyst at Datamonitor

Dheeraj Khiytani's qualifications include an honours degree in Biochemistry from Imperial College and a PhD in HIV Research from the University of Warwick. While at Imperial, Dheeraj assisted Imperial College Laboratories in conducting forensic investigations. Other experience as an undergraduate included time as an assistant conducting research into inherited genetic disorders in Hong Kong.

Dheeraj's PhD concentrated on the structure and function of HIV-1 pre-integration complexes. This research has recently been published in the Journal of General Virology. He has presented papers at the 1999 International Congress of Virology, Sydney and at the European Conference on Experimental AIDS Research, 2001. Dheeraj is Datamonitor's lead HIV analyst and has written numerous HIV specific reports, monthly HIV updates and various briefs on the HIV market.

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