title: Clinical and biochemical evaluation of HIV-related lipodystrophy in an ambulatory population from the Hospital Universitário Cassiano Antonio de Morais, Vitória, ES, Brazil.
abstract: We designed a retrospective cohort study to identify factors associated with HIV-1 related lipodystrophy at a tertiary HIV-care center in Vitória, ES, Brazil. Inclusion criteria were documented HIV diagnosis, anti-retroviral therapy and age above 17 years. Highly active antiretroviral therapy (HAART) was initially the exposure variable, but a second analysis was also performed, as a nested case-control, based on the presence or absence of lipodystrophy. Use of protease inhibitors (PI) was associated with an increase in serum triglycerides (243.7 +/- 189 mg/dL vs. 172.7 +/- 131 mg/dL, p = 0.015), but not of total cholesterol (TC) or HDL fraction levels. Non-nucleoside reverse transcriptase inhibitors (NNRTI) were associated with an increase in serum TC (180.6 +/- 46.8 mg/dL versus 162.4 +/- 41.4 mg/dL; p= 0.018) and an increase in HDL cholesterol (47.3 +/- 13.8 mg/dL versus 23.3 +/- 24.3 mg/dL; p < 0.001), with no significant effect on triglyceride levels. Lipodystrophy was diagnosed in 59.3% of the patients, but exposure to PI versus NNRTI did not affect the frequency of this disorder (43.4% versus 37.2%; p = 0.68). Serum TC, but not HDL cholesterol or triglyceride levels, was higher among the lipodystrophy cases (183.8 +/-47.5 mg/dL versus 162.1 +/-35.7; p=0.006). Among the controls (patients without lipodystrophy), HDL cholesterol (45.3 +/-14.4 mg/dL vs. 27.1 +/-26.3; p=0.001)and triglyceride levels (178.3 +/-146.3 mg/dL vs. 126.3 +/-126.9; p=0.013) also increased, but not TC. In conclusion, lipodystrophy was highly prevalent in our series. Lipid disorders were also frequent and apparently were related to lipodystrophy, except for triglyceride levels.
authors.affiliation: Infectious Diseases Division, Hospital Universitário Cassiano Antonio de Morais. fil.cris@terra.com.br
authors.forename: Bruno Zanotelli
authors.initials: BZ
authors.lastname: Monnerat
authors.forename: Crispim
authors.initials: C
authors.lastname: Cerutti Junior
authors.forename: Sheila Cristina
authors.initials: SC
authors.lastname: Caniçali
authors.forename: Tânia Reuter
authors.initials: TR
authors.lastname: Motta
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D016022:Case-Control Studies; D015331:Cohort Studies; D050171:Dyslipidemias / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000097:blood / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000209:etiology*; D008055:Lipids / Q000097:blood; D008297:Male; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D008055:Lipids