Revista de SIDA e investigación clínica

HIV Lipodystrophy more Prevalent in Women than Men in Tamil Nadu, India

Abstract

Saramma Mini Jacob, Annie Phoebe Kalyanasundaram, Elango Ramesh Kumar, Anitha Durairaj, Hemalatha Ramachandran and Sivakumar MR

Background: As antiretroviral therapy (ART) becomes more available to the HIV infected population in rural areas in India, it is important to determine the prevalence of its long term complications. Therefore, it was proposed to find out the prevalence of lipodystrophy in patients receiving ART and compare the gender dif ferences.

Material and methods: In this cross sectional study, consenting HIV-infected patients on ART visiting Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited. They were on generic first-line fixed dose combinations of ART. Sociodemographics, anthropometric measurements, ART regimens and duration of treatment were recorded. Patients’ self-perception of lipodystrophy was obtained using standardized questionnaires and clinically confirmed by the physician. An overnight fasting blood was drawn to determine serum lipids levels. Statistical analysis included Chi-square test, student t-test and Mann Whitney U test.

Results: There were 145 HIV-infected subjects (46.9% males, 53.1% females) receiving ART for a mean 29.4 months. Mean age of the males were 38.18 ± 8.85 and for the females, it was 33.34 ± 6.20. The mean body mass index (BMI) for the males was 21.95 ± 3.94 kg/m 2 while for the females it was 21.14 ± 3.54 kg/m 2 . The overall prevalence of lipodystrophy was 60.69%; 22.72% with lipohypertrophy, 51.14% with lipoatrophy, and 22.72% with mixed pattern. Women had a higher prevalence of lipodystrophy than men (p=0.004). Lipoatrophy was higher in females (p=0.015) and mixed pattern (p=0.015). There was a higher prevalence of facial atrophy, fat loss in arms, fat loss in legs and fat loss in buttocks among women compared to men. Women with lipodystrophy had higher BMI, CD4 counts, VLDL cholesterol and triglycerides.

Conclusion: Women had significantly higher rates of generalized lipodystrophy and particularly lipoatrophy when compared with men taking first-line antiretroviral regimen. Compared with women without lipodystrophy, those with lipodystrophy had lipid abnormalities.