Risk factors in human immunodeficiency virus/acquired immunodeficiency syndrome patients undergoing antiretroviral therapy in the state of Pernambuco, Brazil: a case-control study.
BACKGROUND
Although human immunodeficiency virus (HIV)-associated lipodystrophy has been reported for more than a decade, there is still considerable uncertainty regarding the mechanisms involved in its pathogenesis.


METHODS
A case-control study was performed that aimed to identify the risk factors for lipodystrophy in HIV/acquired immunodeficiency syndrome (AIDS) patients undergoing antiretroviral therapy in Pernambuco, Brazil.


RESULTS
Between July and November, 2007, a total of 332 patients were enrolled in the study: 182 cases and 150 controls. The following factors were independently associated with lipodystrophy: Use of stavudine [odds ratio (OR), 4.0; 95% confidence interval (CI), 2.3-6.9], use of didanosine (OR, 1.8; 95% CI, 1.0-3.4), use of lopinavir/ritonavir for less than 3 years (OR, 0.5; 95% CI, 0.2-1.0) and use of nucleoside/nucleotide analogue reverse transcriptase inhibitors (NTRIs) for more than 3 years (OR, 2.9; 95% CI, 1.6-5.2). Other associated factors were: duration of antiretroviral therapy (OR, 4.3; 95% CI, 2.4-7.9) and duration of HIV infection (OR, 2.9; 95% CI, 1.8-4.7). There was no association with the use of protease inhibitor when it was adjusted for the use of NRTIs.


CONCLUSIONS
In this study, factors related to antiretroviral therapy were the main risk factors for lipodystrophy, corroborating the literature, but the findings also point to the need for further exploration into some of these associations, especially with the use of didanosine and lopinavir/ritonavir, which are less frequently reported. Future studies with a larger number of patients and a prospective design could provide valuable information for understanding this disorder.
Endocrinology Service, Integral Medicine Institute Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil. thais.gelenske@gmail.com
Thais
T
Gelenske
Francisco Alfredo Bandeira
FA
e Farias
Ricardo Arraes
RA
de Alencar Ximenes
Heloísa Ramos Lacerda
HR
de Melo
Maria de Fátima Pessoa Militão
Mde F
de Albuquerque
Erico Higino
EH
de Carvalho
Zoraya
Z
de Medeiros Barros
George Tadeu Nunes
GT
Diniz
Demócrito de Barros Miranda
Dde B
Filho
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D001938:Brazil; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000821:virology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents