Factors related to lipodystrophy and metabolic alterations in patients with human immunodeficiency virus infection receiving highly active antiretroviral therapy.
Morphologic and metabolic changes associated with protease inhibitor (PI) therapy have been reported since the introduction of PIs for treatment of human immunodeficiency virus infection. These changes were measured 12-20 months after initiation of PI therapy in a cross-sectional study involving 614 patients from the Antiprotéases Cohorte (APROCO) Study (Agence Nationale de Recherches sur le Sida-EP11). The prevalence was 21% for isolated peripheral atrophy, 17% for isolated fat accumulation, 24% for mixed syndrome, 23% for glucose metabolism alterations, 28% for hypertriglyceridemia (triglyceride level, > or =2.2 mM), and 57% for hypercholesterolemia (cholesterol level, > or =5.5 mM). Age was significantly associated with different phenotypes of lipodystrophy and metabolic alterations, but body-mass index, CD4(+) cell count, and type of nucleoside reverse-transcriptase inhibitor or PI received were not constantly associated with these changes. Furthermore, in all models tested, exposure to stavudine was associated with lipoatrophy and exposure of ritonavir was associated with hypertriglyceridemia. Detection and management of these disorders should be implemented to prevent further complications.
Savès
Marianne
M
Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 330, Université Victor Segalen Bordeaux, Bordeaux, France.
Raffi
François
F
Capeau
Jacqueline
J
Rozenbaum
Willy
W
Ragnaud
Jean-Marie
JM
Perronne
Christian
C
Basdevant
Arnaud
A
Leport
Catherine
C
Chêne
Geneviève
G
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism; D006801:Humans; D015228:Hypertriglyceridemia / Q000209:etiology; D008060:Lipodystrophy / Q000209:etiology*; D019438:Ritonavir / Q000009:adverse effects; D018119:Stavudine / Q000009:adverse effects
D018119:Stavudine; D019438:Ritonavir