Revista de SIDA e investigación clínica

Characteristics Associated to Lipodystrophy Syndrome among HIV-Infected Patients Naive and on Antiretroviral Treatment

Abstract

Paulo R Alencastro, Fernando H Wolff, Fabiana Schuelter-Trevisol, Maria Letícia Ikeda, Ajacio B. M. Brandao, Nemora T. Barcellos and Sandra C. Fuchs

Background: HIV-associated lipodystrophy involves changes in complex metabolic networks that are associated with increased cardiovascular risk. It has been associated with the use of combined antiretroviral treatment (cART), particularly Protease Inhibitors (PI) and thymidine analogs. This study aims to evaluate characteristics and use of ART associated with lipodystrophy, lipohypertrophy, and lipoatrophy among HIV-infected patients. Methods: A cross-sectional study was conducted in HIV-infected patients of both genders, aged 18 years or older, who sought care at an HIV/AIDS referral service for diagnostic confirmation or treatment between June 2006 and December 2008. Results: 1240 out of 1295 patients with HIV infection were included. Among patients on cART, women had a higher risk of lipohypertrophy than men, as well as a time since diagnosis of HIV greater than 6 years (versus <3 years). For lipoatrophy, age, education, lifestyle, and body mass index were associated with increased risk. Metabolic parameters were higher among patients on ART; and cART and PI use were independently associated with lipohypertrophy, lipoatrophy and lipodystrophy. The use of IPs can be regarded as responsible for 13% of the association of ART and lipodystrophy, and of 11.5% for the thymidine analogs use, independent of gender, skin color, smoking, CD4, and BMI. Conclusions: Risk factors fo