Prevalence of and clinical factors associated with lipoatrophy in HIV-infected Koreans receiving highly active antiretroviral therapy.
Lipoatrophy is the long-term adverse effects developed in human immunodeficiency virus (HIV)-1-infected subjects receiving highly active antiretroviral therapy (HAART). This cross-sectional study aimed to evaluate the prevalence of and clinical factors associated with lipoatrophy in HIV-infected Koreans receiving HAART for more than 6 months. Lipoatrophy was diagnosed by concordance between physical examination and history taking performed by a single physician. Various covariates were examined, including diabetes mellitus (DM), lipid profiles after HAART, and HAART regimen and duration. Among total 144 patients (6 females and 138 males), 35 patients (24.3%) were diagnosed with lipoatrophy. The prevalence of lipoatrophy was significantly higher in females than that in males [83.3% (5/6) vs. 21.7% (30/138), p = 0.010] and higher in patients with DM than patients without DM [66.7% (4/6 DM) vs. 22.5% (31/138 non-DM), p = 0.030], or in patients with high total cholesterol levels than patients with low total cholesterol levels [31.9% (23/72 patients with high cholesterol) vs. 16.7% (12/72 patients with low cholesterol), p = 0.035]. Moreover, patients with stavudine treatment history (> 12 months) had a higher prevalence of lipoatrophy than patients who never received stavudine [50.0% (15/30) vs. 16.5% (17/103), p < 0.001]. In the multivariate logistic analysis, stavudine treatment for > 12 months (OR, 3.67; p = 0.011) and being female (OR, 24.93; p = 0.009) are independently associated with lipoatrophy. In conclusion, the prevalence of lipoatrophy in HIV-infected Koreans receiving HAART is not uncommon. Limited use of stavudine and regular monitoring are warranted to reduce lipoatrophy.
Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Sang Hoon
SH
Han
Bum Sik
BS
Chin
Hee Kyoung
HK
Choi
So Youn
SY
Shin
Yun Tae
YT
Chae
Ji-Hyeon
JH
Baek
Chang Oh
CO
Kim
Jun Yong
JY
Choi
Young Goo
YG
Song
Hyun Chul
HC
Lee
June Myung
JM
Kim
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D044466:Asian People; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D056910:Republic of Korea / Q000453:epidemiology