Fat distribution in men with HIV infection.
OBJECTIVE
Both peripheral fat loss and central fat gain have been reported in HIV infection. Which changes are specific to HIV were determined by comparison with control subjects and the associations among different adipose tissue depots were determined.


METHODS
Cross-sectional analysis of HIV-positive and control men from the study of Fat Redistribution and Metabolic Change in HIV Infection. Lipoatrophy or lipohypertrophy was defined as concordance between participant report of change and examination. Regional adipose tissue volume was measured by magnetic resonance imaging (MRI).


RESULTS
HIV-positive men reported more fat loss than controls in all peripheral and most central depots. Peripheral lipoatrophy was more frequent in HIV-positive men than in controls (38.3% vs. 4.6%, P < 0.001), whereas central lipohypertrophy was less frequent (40.2% vs. 55.9%, P = 0.001). Among HIV-positive men, the presence of central lipohypertrophy was not positively associated with peripheral lipoatrophy (odds ratio = 0.71, CI: 0.47 to 1.06, P = 0.10). On MRI, HIV-positive men with clinical peripheral lipoatrophy had less subcutaneous adipose tissue (SAT) in peripheral and central sites and less visceral adipose tissue (VAT) than HIV-positive men without peripheral lipoatrophy. HIV-positive men both with and without lipoatrophy had less SAT than controls, with legs and lower trunk more affected than upper trunk. Use of the antiretroviral drugs stavudine or indinavir was associated with less leg SAT but did not appear to be associated with more VAT; nevirapine use was associated with less VAT.


CONCLUSIONS
Both peripheral and central subcutaneous lipoatrophy was found in HIV infection. Lipoatrophy in HIV-positive men is not associated with reciprocally increased VAT.
Bacchetti
Peter
P
University of California, San Francisco Veterans Affairs Medical Center, Metabolism Section, 94121, USA.
Gripshover
Barbara
B
Grunfeld
Carl
C
Heymsfield
Steven
S
McCreath
Heather
H
Osmond
Dennis
D
Saag
Michael
M
Scherzer
Rebecca
R
Shlipak
Michael
M
Tien
Phyllis
P
D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male
D019380:Anti-HIV Agents