Morphologic alterations in HIV-infected people with lipodystrophy are associated with good adherence to HAART.
OBJECTIVE
To evaluate the association between adherence to drugs and morphologic alterations (MOA) in a cohort of HIV-infected patients on HAART.


METHODS
This was a cross-sectional multicenter cohort study in eight tertiary Clinical Centers of Northern and Central Italy. Consecutive outpatients taking HAART were enrolled from August 2000 to March 2001. They completed a self-administered questionnaire for the evaluation of signs of MOA and the self-reported adherence to drugs. Main outcome measures were MOA according to the Multicenter AIDS Cohort Study (MACS) definition and adherence to drugs.


RESULTS
One hundred seventy-five persons were enrolled into the study. Median CD4 cell count was 522 (interquartile range [IQR] 306-720); 35% of people had undetectable HIV RNA. Patients had been taking HAART for a median of 53 months (IQR 33-62). Among enrolled patients, 83 (47%) had a diagnosis of self-reported MOA; 57 of them reported body changes of more than 12 months duration. Forty persons (23%) self-reported nonadherence in the previous week. Mean time on HAART was 48.7 months (SD = 19.7) for people with MOA and 42.1 months (SD = 21.8) for those without MOA (p =.043). The odds of adherence for people with MOA was 2.36 times (95% CI 1.11-5.00) higher than for people without MOA. On multivariate analysis, being older and female, having an undetectable HIV RNA, longer duration on HAART, and self-reported adherence were independently associated with the presence of MOA. In people with MOA, adherence seems to decrease over time.


CONCLUSIONS
Longer time on HAART and self-reported adherence were correlated to MOA. MOA was also associated with older age and female gender.
Guaraldi
Giovanni
G
Department of Medical and Surgery Specialities, infectious Diseases Clinic, University of Modena and Reggio Emilia School of Medicine, Italy. g.guaraldi@unimo.it
Murri
Rita
R
Orlando
Gabriella
G
Orlandi
Emanuele
E
Sterrantino
Gaetana
G
Borderi
Marco
M
Grosso
Carmela
C
Cattelan
Anna Maria
AM
Nardini
Giulia
G
Beghetto
Barbara
B
Antinori
Andrea
A
Esposito
Roberto
R
Wu
Albert W
AW
D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000150:complications; D006801:Humans; D007558:Italy; D008297:Male; D010349:Patient Compliance; D012737:Sex Factors; D011795:Surveys and Questionnaires
D019380:Anti-HIV Agents