Pronounced lipoatrophy in HIV-infected men receiving HAART for more than 6 years compared with the background population.
OBJECTIVE
To establish the prevalence and quantify the severity of body fat redistribution and dyslipidaemia in HIV-infected men after long-term highly active antiretroviral therapy (HAART) compared with the background population.


METHODS
In a cross-sectional study, we included 87 HIV-infected men who had received HAART for at least 6 years and 34 HIV-negative men. Regional body composition was assessed using dual-energy X-ray absorptiometry. Fasting metabolic parameters were obtained. Associations between regional body fat distribution and metabolic parameters were evaluated.


RESULTS
HIV-infected patients and controls did not differ with regard to height and lean body mass. Compared with controls, HIV-infected men had reduced total fat mass (median 12.3 versus 19.2 kg, P<0.001), limb fat mass (4.3 versus 7.9 kg, P<0.001), and trunk fat mass (6.7 versus 10.8 kg, P<0.001) and higher trunk/limb fat ratio (1.7 versus 1.2, P<0.001). Also, patients without clinical lipodystrophy had reduced amounts of limb and trunk fat. In HIV-infected men, triglyceride levels were higher (2.0 versus 1.2 mmol/L, P<0.001), high-density lipoprotein (HDL)-cholesterol levels were lower (1.2 versus 1.3 mmol/L, P<0.05) and insulin levels were higher (40.8 versus 29.9 pmol/L, P<0.01) than in controls. All adverse metabolic parameters correlated with increased trunk/limb fat ratio, and insulin levels correlated positively with trunk fat mass (P<0.01).


CONCLUSIONS
Peripheral as well as central fat loss is a general characteristic of HIV-infected men after long-term HAART. Although lipoatrophy was the dominant morphological presentation, the adverse metabolic parameters were mainly associated with the increased ratio of trunk/limb fat.
Hansen
A B
AB
Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. ann-brit.e.g.hansen@rh.hosp.uk
Lindegaard
B
B
Obel
N
N
Andersen
O
O
Nielsen
H
H
Gerstoft
J
J
D015502:Absorptiometry, Photon; D000328:Adult; D000886:Anthropometry; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001823:Body Composition / Q000187:drug effects; D050218:Body Fat Distribution; D003430:Cross-Sectional Studies; D005121:Extremities / Q000473:pathology; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D039682:HIV-Associated Lipodystrophy Syndrome / Q000097:blood / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D007328:Insulin / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D049629:Waist-Hip Ratio
D019380:Anti-HIV Agents; D007328:Insulin; D008055:Lipids; D019344:Lactic Acid