Lipodsystrophy, or fat redistribution syndrome, has now become the greatest concern for people on or considering begining combination therapy. The First International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, held in San Diego in June 1999, was the first major event held solely to discuss these new body changes. The workshop's primary objective was to present scientific information in the hopes of creating a definition for these syndromes that researchers and clinicians could use to determine who was being impacted by lipodystrophy. The majority of the oral presentations provided background information about the different syndromes and theories about their causes. The most interesting presentations were the studies of mitochondrial toxicities by Dr. Kees Brinkman of the Netherlands, and a series about people around the world with lipodystrophy.
Mitochondria are energy producers inside cells and contain DNA for limited protein construction.
New mitochondria are created by the division of pre-existing mitochondria. Dr. Brinkman pointed out that mitochondrial DNA is prone to damage and is not able to repair damage. Mitochondrial dysfunction can cause many of the common side effects attributed to NRTIs. Dr. Brinkman suggested that mitochondrial toxicities can occur in anyone who has taken a NRTI as part of their long-term therapy. Dr. Brinkman noted that although lipodystrophy was first noted after widespread use of PIs, it is found in people who have never used a PI but have been on NRTIs.