title: Prevalence of and risk factors for lipodystrophy among HIV-infected patients receiving combined antiretroviral treatment in the Asia-Pacific region: results from the TREAT Asia HIV Observational Database (TAHOD).
abstract: The prevalence of and risk factors for lipodystrophy (LD) among patients receiving combined antiretroviral treatment (cART) in the Asia-Pacific region are largely unknown. LD diagnosis was based on the adverse event definition from the US NIH Division of AIDS (2004 version), and only cases with a severity grade of ≥ 3 were included. TAHOD patients who had recently commenced cART with ≥ 3 drugs after 1996 from sites which had ever reported LD were included in the analysis. Covariates for the forward multivariate logistic regression model included demographic variables, CDC disease classification, baseline CD4 and viral load, hepatitis B/C virus co-infection, and regimen and duration of cART. LD was diagnosed in 217 (10.5%) of 2072 patients. The median duration of cART was 3.8 (interquartile range, 2.2-5.3) years [stavudine, 2.0 (1.0-3.5) years; zidovudine, 1.8 (0.6-3.9) years; and protease inhibitors (PI), 2.6 (1.3-4.5) years]. In the multivariate model, factors independently associated with LD included use of stavudine (≤ 2 years vs. no experience: OR 25.46, p<0.001, > 2 years vs. no experience: OR 14.92, p<0.001), use of PI (> 2.6 years vs. no experience: OR 0.26, p<0.001), and total duration of cART (> vs. ≤ 3.8 years: OR 4.84, p<0.001). The use of stavudine was strongly associated with LD in our cohort. Stavudine-sparing cART strategies are warranted to prevent the occurrence of LD in the Asia-Pacific region.
authors.affiliation: Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Han
authors.forename: Jialun
authors.initials: J
authors.lastname: Zhou
authors.forename: Suneeta
authors.initials: S
authors.lastname: Saghayam
authors.forename: Sasheela
authors.initials: S
authors.lastname: Vanar
authors.forename: Nittaya
authors.initials: N
authors.lastname: Phanuphak
authors.forename: Yi-Ming A
authors.initials: YM
authors.lastname: Chen
authors.forename: Thira
authors.initials: T
authors.lastname: Sirisanthana
authors.forename: Somnuek
authors.initials: S
authors.lastname: Sungkanuparph
authors.forename: Christopher K C
authors.initials: CK
authors.lastname: Lee
authors.forename: Sanjay
authors.initials: S
authors.lastname: Pujari
authors.forename: Patrick C K
authors.initials: PC
authors.lastname: Li
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
authors.forename: Vonthanak
authors.initials: V
authors.lastname: Saphonn
authors.forename: Fujie
authors.initials: F
authors.lastname: Zhang
authors.forename: Tuti Parwati
authors.initials: TP
authors.lastname: Merati
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Law
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D001208:Asia / Q000453:epidemiology; D044466:Asian People; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D018119:Stavudine / Q000009:adverse effects*; D044465:White People
chemical_list: D018119:Stavudine