About AIDS

HIV-poz folks taking the drug cocktail (or HAART) frequently experience long-term side effects called metabolic disorders. This affects 25%-40% of patients taking HAART for only two years, and the likelihood of metabolic problems rises the longer the drugs are taken. The causes are not clear. It could be the HIV drugs or a combination of HIV itself plus the drugs.

The most outwardly noticeable metabolic disorder is lipodystrophy, an abnormal distribution of fat in the body. However, the more immediately dangerous problem is invisible: diabetes. The HIV-positive person's body begins to lose control of insulin production. Glucose is the essential fuel the body uses for energy. Insulin is the hormone that enables the glucose to enter cells to be used, or metabolized, but people on the HIV meds often develop insulin resistance. If the delicate balance between insulin and glucose is upset, the person develops Type II diabetes (adult-onset diabetes), even without inherited risk factors. Complications can include kidney failure, nerve damage, blindness, circulatory problems, even death.

Some people already have an inherited risk for diabetes, especially African Americans and Latinos. Anyone taking AIDS drugs needs to be aware of this potential problem and take appropriate care, following a program including exercise, careful diet, and weight management. The physician may also prescribe insulin-sensitizing medication.

If you have questions about your HIV meds and diabetes, talk with your doctor. ASA has an excellent booklet from the National Association of People with AIDS called "Your Guide to Understanding Lipodystrophy Syndrome."