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

Abstract

As antiretroviral therapy (ART) becomes more available to the HIV-infected population, it is important to determine the prevalence of its long-term complications. In this cross-sectional study, 145 HIV-positive patients on ART, 146 HIV-positive patients not on ART, and 72 HIV-negative individuals visiting the Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited from February 2007 to April 2009. Among the patients on ART, the prevalence of lipodystrophy was 60.7%; 22.7% with lipohypertrophy, 51.1% with lipoatrophy, and 22.7% with mixed pattern. The proportion of patients with dyslipidemia was significantly higher in the treatment group when compared to ART-naive and HIV-negative controls (P ¼ .00). Total duration of ART was significantly associated with lipodystrophy (P ¼ .04) and dyslipidemia (P ¼ .01). Also, by logistic regression, abnormal metabolic levels were a risk factor in lipodystrophy (P ¼ .02). This study highlights the need for development of inexpensive and accessible treatments for the reduction of lipodystrophy.

Lipodystrophy syndrome among HIV infected children on highly active antiretroviral therapy in northern India

“…In our study lipodystrophy was observed in 33.7%. Few studies on stavudine based HAART have reported a prevalence between 27% -60.7 % ( 8,22,28,29,30,(33)(34) . We found lipoatrophy as the commonest subtype similar to others (8,11,12,20,21,33,34) whereas Aurpibul et al (22) reported lipohypertrophy as the commonest subtype.…”

“…The mechanism responsible for this syndrome remains unclear. It has been proposed that antiretroviral drugs such as protease inhibitors (PI) and/ or nucleoside analogues (stavudine) could contribute to the development of such clinical and metabolic abnormalities (2,6,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(28)(29)(30)(31)(32)(33)(34)(35) . Various risk factors have been found to be associated with the development of lipodystrophy like older age and increasing duration of treatment (22,33,34,35) .…”

Change in serum lipid profiles and glucose after switching from stavudine/lamivudine to zidovudine/lamivudine in non-nucleoside reverse transcriptase inhibitors based anti-retroviral regimens in Southern Ethiopia

“…The association between dyslipidemia and HAART has been mainly described for PIs based regimens (Anastos et al, 2007;Nery et al, 2011). Lipid derangements were higher among patients who received d4T when compared with other NRTIs (Kalyanasundaram et al, 2012;Ceccato et al, 2011). NNRTIs derange lipid profiles during therapy (Van der Valk et al, 2001;Young et al, 2005); however, evidences in support of the characterization of dyslipidemia regarding NNRTIs after HAART switching in sub-Saharan African countries are scarce.…”

Influence of Antiretroviral Therapy on the Metabolic Profile of People Living with HIV Followed at University Hospital, Cotonou, Benin

“…Lipodystrophy was observed in nearly one patient treated for three, and more than half of the cases were the atrophic form. Others have made the same observation emphasizing the determining role of stavudine which was widely used in most national programs in developing countries [5] [7] [11]. The impact of ART on the occurrence of metabolic syndrome is due to the mechanism of action of ARVs Drugs which determine dysfunction of lipid and glucose metabolism of patients [12]- [15].…”