Regional adipose tissue measured by MRI over 5 years in HIV-infected and control participants indicates persistence of HIV-associated lipoatrophy

Grünfeld, Carl; Saag, Michael S.; Cofrancesco, Joseph; Lewis, Cora E.; Kronmal, Richard A.; Heymsfield, Steven B.; Tien, Phyllis C.; Bacchetti, Peter; Shlipak, Michael G.; Scherzer, Rebecca

doi:10.1097/qad.0b013e32833ac7a2

Cited by 71 publications

(63 citation statements)

References 31 publications

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“…19,20,22 Although some studies have demonstrated an association between lipoatrophy and use of specific PIs or NRTIs, 19,22 others have shown no ARV-specific effects, 20 and it has been observed that HIV-1-infected subjects, in general, have lower levels of PAT compared with uninfected control subjects. 57 The increase in PAT in the DRV/r arm of this study, which had more advanced disease at baseline compared with the ATV/r arm, can be considered as potentially favorable; however, the small sample size and short duration of this trial limit clinical interpretation of these data.…”

Section: Discussionmentioning

confidence: 93%

Metabolic Effects of Darunavir/Ritonavir Versus Atazanavir/Ritonavir in Treatment-Naive, HIV Type 1-Infected Subjects over 48 Weeks

Aberg

Tebas

Overton

et al. 2012

AIDS Research and Human Retroviruses

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We assessed metabolic changes for darunavir/ritonavir (DRV/r) once daily (qd) versus atazanavir/ritonavir (ATV/r) qd with fixed-dose tenofovir/emtricitabine. This was a phase 4, multicenter, open-label, randomized exploratory study. Treatment-naive, HIV-1-infected adults received DRV/r 800/100 mg qd or ATV/r 300/ 100 mg qd, both with emtricitabine/tenofovir 200/300 mg qd. Primary end point: change in triglyceride levels from baseline to week 12. Secondary end points: week 12 and week 48 changes in lipid parameters, insulin sensitivity, inflammatory/coagulation/bacterial translocation biomarkers, viral load, CD4 + cell count, and week 48 changes in adipose tissue distribution and subjects' perceptions of body changes. In the DRV/r arm, 32/34 and 29/34 subjects completed weeks 12 and 48, respectively; in the ATV/r arm, 30/31 and 25/31 subjects completed weeks 12 and 48, respectively. Small changes in lipid parameters from baseline to weeks 12 and 48 were observed in both arms. Differences were noted between arms in mean changes in total cholesterol (DRV/r, 20.3 mg/dl; ATV/r, 4.6 mg/dl) and apolipoprotein A1 (DRV/r, 10.7 mg/dl; ATV/r, -0.7 mg/dl) at week 12. At week 48, no clinically relevant differences between arms were noted for changes in any lipid parameter, fasting glucose, or insulin sensitivity. Biomarkers generally decreased and efficacy parameters improved in both arms over 48 weeks. Changes in adipose tissue were small and comparable between arms. Subjects' perceptions of body changes generally improved in both study arms. This first pilot comparison in HIV-1-infected subjects suggests that DRV/r has a metabolic profile similar to ATV/r over 48 weeks of treatment. Further randomized studies are warranted.

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Section: Discussionmentioning

confidence: 93%

Metabolic Effects of Darunavir/Ritonavir Versus Atazanavir/Ritonavir in Treatment-Naive, HIV Type 1-Infected Subjects over 48 Weeks

Aberg

Tebas

Overton

et al. 2012

AIDS Research and Human Retroviruses

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“…Patients with lipodystrophy also commonly have increased abdominal adiposity, chest adiposity, and increased glandular breast tissue, the latter known as gynecomastia. While some patients have only lipoatrophy (Grunfeld et al 2010), others over time develop signs and symptoms of lipohypertrophy as well. Many patients have associated internal and metabolic abnormalities such as diabetes, advanced coronary disease, and cardiomyopathy.…”

Section: Lipodystrophymentioning

confidence: 99%

Novel Liposuction Techniques for the Treatment of HIV-Associated Dorsocervical Fat Pad and Parotid Hypertrophy

Abrams¹,

Herbst²

2011

Advanced Techniques in Liposuction and Fat Transfer

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“…Preliminary data include the demonstration of altered lipolysis and increased serum free fatty acids in HIV-positive individuals (Koster et al, 2003). Excess free fatty acids in the circulation may reduce insulin sensitivity through inappropriate lipid storage in muscle and liver, resulting in impaired glucose utilization and insulin-mediated inhibition of glycogenolysis and gluconeogenesis (Grunfeld et al, 2010). PI therapy is associated with higher rates of diabetes mellitus, impaired glucose tolerance, and hyperinsulinemia among HIVpositive individuals.…”

Section: Haart and Cardiovascular Diseasementioning

confidence: 99%

“…And as we have heard many times, certain factors increase the risk of cardiac disease regardless of HIV status. If a person exhibits three or more of these risk factors, he is considered to have Metabolic Syndrome (Capeau et al, 2012;Grunfeld et al, 2010). These risk factors include: The presence of metabolic syndrome increases the risk of heart disease in people with or without HIV.…”

Section: Hiv Infection and Cardiovascular Diseasementioning

confidence: 99%

Human Immunodeficiency Virus infection and cardiovascular disease

2017

Int. J. Curr. Res. Med. Sci.

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The human immunodeficiency virus (HIV) is a retrovirus belonging to the family of lentiviruses. Retroviruses are so named because they reverse the normal flow of genetic information. In all cellular organisms the genetic material is DNA. Retroviruses use their RNA and host DNA to make viral DNA. Infection with HIV causes severe damage to the immune system leading to Acquired Immune Deficiency Syndrome (AIDS). Individuals infected with HIV show both cellular and humoral (antibody) immune responses to the virus, but these responses are unable to prevent the ultimate progression of disease in the great majority of infected individuals. Depletion of CD4 lymphocytes is the hallmark of HIV infection, and predicts an individual's risk for infection with opportunistic pathogens as well as other complications of HIV disease. There is a great association of HIV and cardiovascular disease due to a higher prevalence of underlying traditional cardiovascular risk factors that are mostly host dependent. Most of the HIV drugs increase the chances of cardiovascular diseases in the patients especially protease inhibitors. Chronic inflammation, hypercoagulability and platelet activation all contribute to endothelial dysfunction, and are a probable link between HIV and cardiovascular disease.

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Regional adipose tissue measured by MRI over 5 years in HIV-infected and control participants indicates persistence of HIV-associated lipoatrophy

Cited by 71 publications

References 31 publications

Metabolic Effects of Darunavir/Ritonavir Versus Atazanavir/Ritonavir in Treatment-Naive, HIV Type 1-Infected Subjects over 48 Weeks

Metabolic Effects of Darunavir/Ritonavir Versus Atazanavir/Ritonavir in Treatment-Naive, HIV Type 1-Infected Subjects over 48 Weeks

Novel Liposuction Techniques for the Treatment of HIV-Associated Dorsocervical Fat Pad and Parotid Hypertrophy

Human Immunodeficiency Virus infection and cardiovascular disease

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