Therapeutic Approaches to HAART-Induced Lipodystrophy

Inclusion Criteria - General inclusion: * Age \> 14 years * HIV infection being treated with HIV-1 protease inhibitors for \>6 months currently, or previous protease inhibitor therapy of at least 2 years duration with development of lipodystrophy and current stable therapy preferably for past 4 months. * Fasting serum triglycerides \> 200 mg/dL Exclusion Criteria - General exclusion: * Acute, ongoing AIDS-defining opportunistic infections. * Blood CD4 positive lymphocyte count \< 200/mm3 * Known liver disease due to causes other than nonalcoholic steatohepatitis with elevation of liver transaminases by more than two and a half times above the upper limits of normal (SGOT\>105 U/L, SGPT\>120 U/L) or total bilirubin (\>1.5 mg/dL). * Hematocrit of less than 30%. * Current alcohol abuse (\>7 drinks or 210 g per wk for women and \>14 drinks or 420 g per wk for men). * Current substance abuse. * Uncontrolled diabetes mellitus with fasting plasma glucose \> 180 mg/dL or hemoglobin A1c \> 9%. * History of weight loss during the last 3 months. * Use of anorexiogenic drugs, thiazolidinediones, anabolic steroids and human growth hormone. * Major Neuro-psychiatric illnesses impeding competence or compliance. * Pregnant and lactating women. * Cancer excluding skin cancer other than melanoma. * Acute medical illnesses precluding participation in the studies. * Chronic renal insufficiency with serum creatinine \> 2 mg/dL. * Untreated thyroid disorders such as hypothyroidism and hyperthyr…