People taking Avandia (rosiglitazone) to treat HIV-associated fat loss had unhealthy changes in cholesterol that can lead to heart problems, according to a study published in the November 30 issue of AIDS.

Colleen Hadigan, MD, from the laboratory of immunoregulation at the National Institute of Health in Bethesda, Maryland, and her colleagues enrolled 26 HIV-positive people with lipoatrophy into a study evaluating the safety and effectiveness of Avandia, an oral diabetes medication that may reverse facial fat loss caused by some HIV medications. Previously published results of this trial found that people taking Avandia were more likely to have increases in LDL, the “bad” cholesterol, than people who received a placebo. In this study, Dr. Hadigan’s team looked at the size and density of the LDL and HDL, the “good” cholesterol, in the study participants. This is relevant because a decrease in the size of LDL and HDL particles is associated with a greater risk of heart problems.

The team found that although the particle size of LDL did not change, the size of the HDL particles decreased in people taking Avandia, compared with people taking a placebo. Dr. Hadigan cautions that although the study size is small, the negative trend in HDL particle size changes should be taken into account when doctors are weighing the potential risks and benefits of treatment with Avandia.