Does race protect an oriental population from developing lipodystrophy in HIV-infected individuals on HAART?
OBJECTIVE
Lipodystrophy, hyperlipidaemia and hyperinsulinaemia are common metabolic complications of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected Caucasians. We questioned whether such complications also occur in other races.


METHODS
A cross-sectional analysis was performed in an outpatient clinic of a university teaching hospital with 156 Koreans, divided into HIV-infected subjects receiving HAART (n=57, group 1), HAART-naïve subjects (n=42, group 2), and healthy controls (n=57, group 3). Lipodystrophy was assessed by physical examination and questionnaire and body composition by dual-energy X-ray absorptiometry. Fasting triglyceride, total cholesterol, low-density (LDL) and high-density lipoprotein (HDL) cholesterol, free fatty acid (FFA), Apolipoprotein A1 (ApoA1), Apolipoprotein B (ApoB), glucose, insulin, c-peptide, leptin, cortisol, dehydroepiandrosterone (DHEA), CD4, CD8 lymphocyte counts and HIV RNA load were measured.


RESULTS
Lipodystrophy was observed in only 3.5% of HAART-treated HIV-infected Koreans. No statistical difference in regional fat accumulation or peripheral fat wasting was observed between groups 1, 2 and 3. No statistical difference in triglyceride, total cholesterol, LDL cholesterol, FFA, ApoA1, ApoB, glucose, insulin, C-peptide, leptin, cortisol, and DHEA were observed between groups 1, 2 and 3. HDL cholesterol was significantly lower in HIV-infected individuals compared to controls.


CONCLUSIONS
Lipodystrophy, hyperlipidaemia, and insulin resistance are rare metabolic complications of HAART in an oriental HIV-infected group of individuals. These findings warrant further race-specific metabolic complication studies in HIV-infected subjects receiving HAART.
Chang
K H
KH
Department of Internal Medicine, Yonsei University College of Medicine, 120-752, Seoul, Korea.
Kim
J M
JM
Song
Y G
YG
Hong
S K
SK
Lee
H C
HC
Lim
S K
SK
D015502:Absorptiometry, Photon; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D044466:Asian People; D001823:Body Composition; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV / Q000235:genetics; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008060:Lipodystrophy / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D011795:Surveys and Questionnaires; D019562:Viral Load
D012367:RNA, Viral