Clinical and biochemical evaluation of HIV-related lipodystrophy in an ambulatory population from the Hospital Universitário Cassiano Antonio de Morais, Vitória, ES, Brazil.
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.
Monnerat
Bruno Zanotelli
BZ
Infectious Diseases Division, Hospital Universitário Cassiano Antonio de Morais. fil.cris@terra.com.br
Cerutti Junior
Crispim
C
Caniçali
Sheila Cristina
SC
Motta
Tânia Reuter
TR
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
D015415:Biomarkers; D008055:Lipids