Abnormalities of Body Fat Distribution in HIV-Infected Persons Treated With Antiretroviral Drugs

Abstract

We prospectively assessed the 1-month prevalence of abnormal body fat distribution in HIV-infected individuals. Of 1,359 patients treated with antiretroviral drugs, 578 (43%) had signs of abnormal fat distribution. Peripheral fat loss was observed in 382 patients (28%), whereas 412 (30%) had signs of fat accumulation. The presence of lipodystrophy (peripheral fat loss with or without fat accumulation) was found to be independently associated with increasing age (less than 35 years of age as a reference group: 35 to 41 years of age, OR = 1.5 [95% CI, 1.1-2.3]; and older than 41 years of age, OR = 2.4 [95% CI, 1.7-3.5]), current use of stavudine (OR = 2.4 [95% CI, 1.8-3.3]), current use of abacavir (OR = 2.1 [95% CI, 1.3-3.4]), and elevated lactate level (OR = 1.6 [95% CI, 1.1-2.4]). The prevalence of lipodystrophy was higher among patients who had received stavudine for a longer period (no stavudine in the current combination as a reference group: <6 months, OR = 1.1 [95% CI, 0.6-1.8]; 6-24 months, OR = 2.4 [95% CI, 1.7-3.5]; and >24 months, OR = 3.2 [95% CI, 2.4-4.3]). This study confirms the association between the use of stavudine and lipodystrophy.

Depleted skeletal muscle mitochondrial DNA, hyperlactatemia, and decreased oxidative capacity in HIV‐infected patients on highly active antiretroviral therapy

“…Stavudine has been associated consistently with mitochondrial toxicity [Walker et al, 2002], hyperlactatemia [John et al, 2001], peripheral lipoatrophy [Bernasconi et al, 2002], and peripheral neuropathy [Moyle and Sadler, 1998], which comply with our present findings. The present results may support the view that patients on stavudine should be considered switched to other less toxic NRTIs [Gallant et al, 2004;Saag et al, 2004;Sande and Ronald, 2004].…”

Prevalence of Lipodystrophy and Dyslipidemia among Patients with HIV Infection on Generic ART in Rural South India

“…Studies have been documented from developed countries with high prevalence of lipodystrophy; similar to the finding of our study. 16,17 We observed that gender may play a role in the prevalence of lipodystrophy in this rural population, with the female gender reporting a higher prevalence. Similar observations were reported from South Africa and Senegal.…”

Progression of Lipodystrophy (LD) with Continued Thymidine Analogue Usage: Long-Term Follow-Up from a Randomized Clinical Trial (The PIILR Study)

“…However, our study used objective measures for changes in LD, compared with many studies that have utilized only subjective assessments of LD. 7,26 The finding of a significant increase in the LDCS over the 120 weeks, without significant changes in any other primary or secondary endpoint, may be due to subtle changes that occurred within the LDCS calculation. The factors that comprise the LDCS are age, sex, duration of HIV infection, CDC classification, HDL cholesterol, anion gap, waist:hip ratio, VAT:SAT ratio, trunk:limb ratio, and leg fat percentage.…”