title: Prevalence of obesity and its relationship to clinical lipodystrophy in HIV-infected adults on anti-retroviral therapy.
abstract: BACKGROUND
  Combination antiretroviral therapy (cART) is associated with lipodystrophy (lipoatrophy and lipoaccumulation) and several metabolic abnormalities that together can contribute to an increased cardiovascular risk. The aim of this study was to evaluate the prevalence of obesity in patients on cART according to the presence of clinical lipodystrophy (CL) and to analyze factors associated with obesity.
  
  
  METHODS
  We evaluated 368 HIV-infected adults on cART.
  
  
  RESULTS
  CL was present in 59.0%. Independently of gender, patients with CL were more frequently underweight [5.7% (21/368)] and of normal weight [47.3% (174/368)], and less frequently overweight [33.2% (122/368)] or obese [13.9% (51/368)]. Mean body mass index was higher in patients with abdominal prominence regardless of the presence of clinical lipoatrophy. Patients with CL had lower waist circumference, higher waist/hip and fat mass ratio and lower total and subcutaneous fat, without significant difference in visceral fat but with a higher visceral/subcutaneous fat ratio, as evaluated by CT at abdominal level. CL was significantly less frequent in overweight [odds ratio (OR)=0.21, 95% confidence interval (CI): 0.05-0.92] and obese (OR=0.05, 95%CI: 0.01-0.26) patients, when compared to underweight ones, independent of age, gender, duration of infection, cART regimen, virological suppression, and HIV-infection risk factor.
  
  
  CONCLUSIONS
  Being overweight or obese is highly prevalent in HIV-infected patients on cART. Patients with CL were more frequently under- or normal weight, and less frequently overweight or obese. Obesity is a condition that should be considered in HIV patients on cART.
authors.affiliation: Department of Endocrinology, Hospital de São João and University of Porto Medical School, Alameda Hernâni Monteiro, Porto, Portugal. paula_freitas@sapo.pt
authors.forename: P
authors.initials: P
authors.lastname: Freitas
authors.forename: D
authors.initials: D
authors.lastname: Carvalho
authors.forename: A C
authors.initials: AC
authors.lastname: Santos
authors.forename: M J
authors.initials: MJ
authors.lastname: Matos
authors.forename: A J
authors.initials: AJ
authors.lastname: Madureira
authors.forename: R
authors.initials: R
authors.lastname: Marques
authors.forename: E
authors.initials: E
authors.lastname: Martinez
authors.forename: A
authors.initials: A
authors.lastname: Sarmento
authors.forename: J L
authors.initials: JL
authors.lastname: Medina
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001823:Body Composition; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015497:HIV-1 / Q000302:isolation & purification*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000821:virology*; D011174:Portugal; D012367:RNA, Viral / Q000097:blood; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral