title: Incidence of lipoatrophy and lipohypertrophy in the women's interagency HIV study.
abstract: OBJECTIVE
  To estimate the incidence of lipoatrophy and lipohypertrophy among HIV-infected and HIV-uninfected women from the Women's Interagency HIV Study.
  
  
  METHODS
  Eight hundred fifteen women with semiannual data on self-report of bidirectional change in body fat, anthropometric measurements, weight, and bioelectric impedance analysis were included in a 30-month incidence analysis.
  
  
  METHODS
  Lipoatrophy and lipohypertrophy in both peripheral (arms, legs, and buttocks) and central (waist, chest, and upper back) sites were defined by self-report of either a decrease or an increase in a body fat region over the previous 6 months that was confirmed by a corresponding change in anthropometric measurement.
  
  
  RESULTS
  Weight and total body fat increased in HIV-uninfected women but remained stable in HIV-infected women over 30 months. Among HIV-infected women, the incidence of peripheral (relative hazard, 2.1; 95% confidence interval [CI], 1.4-3.3) and central (relative hazard, 1.9; 95% CI, 1.2-2.8) lipoatrophy was about double that among HIV-uninfected women, after adjustment for age and race. The incidence of peripheral lipohypertrophy appeared lower among HIV-infected women than among HIV-uninfected women (relative hazard, 0.8; 95% CI, 0.6-1.1), while the incidence of central lipohypertrophy did not differ by HIV status. Of HIV-infected women with 2 of 4 lipodystrophy outcomes, most (81%) had combined peripheral and central lipoatrophy or combined peripheral and central lipohypertrophy. Only 14% of these women had both peripheral lipoatrophy and central lipohypertrophy.
  
  
  CONCLUSIONS
  These prospective data suggest that lipoatrophy, affecting both peripheral and central sites, predominates in HIV-infected women. The simultaneous occurrence of peripheral lipoatrophy and central lipohypertrophy was uncommon.
authors.affiliation: Department of Medicine, University of California at San Francisco, San Francisco Veterans Affairs Medical Center, San Francisco, CA 94121, USA. ptien@medicine.ucsf.edu
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cole
authors.forename: Carolyn Masters
authors.initials: CM
authors.lastname: Williams
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Justman
authors.forename: Mardge H
authors.initials: MH
authors.lastname: Cohen
authors.forename: Mary
authors.initials: M
authors.lastname: Young
authors.forename: Nancy
authors.initials: N
authors.lastname: Rubin
authors.forename: Michael
authors.initials: M
authors.lastname: Augenbraun
authors.forename: Carl
authors.initials: C
authors.lastname: Grunfeld
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology; D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000473:pathology*; D000328:Adult; D001284:Atrophy; D001827:Body Height; D001835:Body Weight; D005260:Female; D015658:HIV Infections / Q000473:pathology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000473:pathology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D006984:Hypertrophy; D015994:Incidence; D008875:Middle Aged; D009929:Organ Size; D044469:Racial Groups; D013997:Time Factors; D014481:United States