title: High prevalence and impact on the quality of life of facial lipoatrophy and other abnormalities in fat tissue distribution in HIV-infected patients treated with antiretroviral therapy.
abstract: Few data report the prevalence in actual clinical settings of lipodystrophy (LD), and in particular of facial lipoatrophy (LA), in HIV-infected patients treated with long-term antiretroviral therapy (ART). A French, multicenter, cross-sectional, observational study was conducted in HIV-infected patients on continuous ART for more than 12 months. The main objective was to assess the prevalence of facial LA in this population. Additional objectives were to make the same assessments for nonfacial LA and lipohypertrophy. The presence of LD signs, type, and severity was assessed by clinicians and compared with patient self-evaluations through two questionnaires. A total of 2,131 assessable patients had a median age of 46 years and a median time on ART of 10 years. Physicians diagnosed facial LA in 54% of patients and these subjects had received ART for a longer duration than those without LA. Thymidine analog usage was associated with an increased likelihood of facial LA, but 28% of patients recently treatment-initiated (1-5 years) were also affected. At other sites, LA and lipohypertrophy were diagnosed in 59% and 57% of cases, respectively. The concordance between physician and patient assessments was good for facial and buttocks LA. In this study, facial LA affects more than half of the subjects and is frequent even among the most recently treated patients. The prevalence of facial LA significantly increases with the duration of ART, with male gender, hepatitis C virus (HCV) coinfection, and non-African origin being independent risk factors. Lipohypertrophy is frequent and appears early after ART initiation.
authors.affiliation: CHU, Grenoble, France. pleclercq@chu-grenoble.fr
authors.forename: Pascale
authors.initials: P
authors.lastname: Leclercq
authors.forename: Cecile
authors.initials: C
authors.lastname: Goujard
authors.forename: Martin
authors.initials: M
authors.lastname: Duracinsky
authors.forename: François
authors.initials: F
authors.lastname: Allaert
authors.forename: Marianne
authors.initials: M
authors.lastname: L'henaff
authors.forename: Maeva
authors.initials: M
authors.lastname: Hellet
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Meunier
authors.forename: Sophie
authors.initials: S
authors.lastname: Carret
authors.forename: Jacques
authors.initials: J
authors.lastname: Thevenon
authors.forename: Philippe
authors.initials: P
authors.lastname: Ngo Van
authors.forename: Gilles
authors.initials: G
authors.lastname: Pialoux
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005145:Face; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents