title: Ethnicity and gender differences in lipodystrophy of HIV-positive individuals taking antiretroviral therapy in Ontario, Canada.
abstract: OBJECTIVE
  This study assessed ethnicity and gender differences in prevalence, type, and severity of antiretroviral-associated lipodystrophy in HIV-positive individuals in Ontario.
  
  
  METHODS
  This was a cross-sectional analysis of the Ontario Cohort Study (OCS), a prospective study of HIV-positive patients in Ontario. Lipodystrophy was defined as at least 1 major or 2 minor self-reported changes of peripheral lipoatrophy and/or central lipohypertrophy. Prevalence, type, and severity were compared by ethnicity (Black, White, or Other) and gender. Univariate and multivariate logistic regression analyses identified predictors of lipodystrophy.
  
  
  RESULTS
  Data were available for 778 participants (659 men, 119 women). There were 517 Whites, 121 Blacks, and 140 patients of Other ethnicities. In univariate analyses, Whites reported more peripheral lipoatrophy (P = .004) and abdominal lipohypertrophy (P = .04); these ethnic differences were observed in males (P = .05 and P = .03, respectively) but not females. Males reported more peripheral lipoatrophy (P = .01), whereas females had more central lipohypertrophy (P < .0001) and mixed fat redistribution (P < .0001). Multivariable regression analyses revealed Black women to be most vulnerable to lipodystrophy (P = .02), particularly lipohypertrophy (P < .0001).
  
  
  CONCLUSIONS
  Ethnicity and gender are important factors influencing lipodystrophy. Combining lipoatrophy and lipohypertrophy into a single entity is not appropriate. Black women were most vulnerable to lipohypertrophy, which has important implications for antiretroviral therapy roll-out in Africa.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Nisha
authors.initials: N
authors.lastname: Andany
authors.forename: Janet M
authors.initials: JM
authors.lastname: Raboud
authors.forename: Sharon
authors.initials: S
authors.lastname: Walmsley
authors.forename: Christina
authors.initials: C
authors.lastname: Diong
authors.forename: Sean B
authors.initials: SB
authors.lastname: Rourke
authors.forename: Sergio
authors.initials: S
authors.lastname: Rueda
authors.forename: Anita
authors.initials: A
authors.lastname: Rachlis
authors.forename: Wendy
authors.initials: W
authors.lastname: Wobeser
authors.forename: Rodger D
authors.initials: RD
authors.lastname: Macarthur
authors.forename: Louise
authors.initials: L
authors.lastname: Binder
authors.forename: Ron
authors.initials: R
authors.lastname: Rosenes
authors.forename: Mona R
authors.initials: MR
authors.lastname: Loutfy
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D044383:Black People; D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced* / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012727:Sex Characteristics; D044465:White People
chemical_list: D019380:Anti-HIV Agents