Acipimox to Improve Hyperlipidemia and Insulin Sensitivity Associated With HIV

Inclusion Criteria: * Documented HIV infection * Stable antiretroviral regimen for greater than 3 months * Hypertriglyceridemia (fasting triglycerides greater than 150mg/dl) * Evidence of fat redistribution (e.g., increased abdominal or cervical fat, and/or decreased subcutaneous fat of the face, arms, or legs) on physical exam Exclusion Criteria: * Current therapy with a lipid lowering medication (e.g., fibrates, HMG CoA reductase inhibitors, resins) or treatment with these agents in the 3 months prior to study entry * Current use of hormone replacement therapy, oral contraceptives for women, or supraphysiologic testosterone therapy in men * Fasting triglycerides greater than 1000mg/dl * Active alcohol or substance abuse * Active peptic ulcer disease * History of renal failure or serum creatinine greater than 2.0 * Serious opportunistic infection within the 3 months prior to study entry * Hemoglobin less than 11.0 mg/dl * Elevated transaminase levels (AST or ALT greater than 2.5x the upper limit of normal) * Previously diagnosed diabetes mellitus or patients receiving current treatment for diabetes