Discordance between body mass index and anthropometric measurements among HIV-1-infected patients on antiretroviral therapy and with lipoatrophy/lipohypertrophy syndrome.
BACKGROUND
Highly Active Antiretroviral Therapy (HAART) has improved and extended the lives of thousands of people living with HIV/AIDS around the world. However, this treatment can lead to the development of adverse reactions such as lipoatrophy/lipohypertrophy syndrome (LLS) and its associated risks.


OBJECTIVE
This study was designed to assess the prevalence of self-reported lipodystrophy and nutritional status by anthropometric measurements in patients with HIV/AIDS.


METHODS
An observational study of 227 adult patients in the Secondary Immunodeficiencies Outpatient Department of Dermatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo (3002 ADEE-HCFMUSP). The sample was divided into three groups; Group 1 = 92 patients on HAART and with self-reported lipodystrophy, Group 2 = 70 patients on HAART without self-reported lipodystrophy and Group 3 = 65 patients not taking HAART. The nutritional status of individuals in the study sample was determined by body mass index (BMI) and percentage of body fat (% BF). The cardiovascular risk and diseases associated with abdominal obesity were determined by waist/hip ratio (WHR) and waist circumference (WC).


RESULTS
The prevalence of self-reported lipoatrophy/lipohypertrophy syndrome was 33% among women and 59% among men. Anthropometry showed depletion of fat mass in the evaluation of the triceps (TSF) in the treatment groups with HAART and was statistically independent of gender; for men p = 0.001, and for women p = 0.007. Similar results were found in the measurement of skin folds of the upper and lower body (p = 0.001 and p = 0.003 respectively). In assessing the nutritional status of groups by BMI and % BF, excess weight and body fat were more prevalent among women compared to men (p = 0.726). The WHR and WC revealed risks for cardiovascular and other diseases associated with abdominal obesity for women on HAART and with self-reported LLS (p = 0.005) and (p = 0.011).


CONCLUSIONS
Anthropometric measurements were useful in the confirmation of the prevalence of LLS. BMI alone does not appear to be a good parameter for assessing the nutritional status of HIV-infected patients on HAART and with LLS. Other anthropometric measurements are needed to evaluate patients with the lipoatrophy/lipohypertrophy syndrome.
Dermatology Department, Secondary Immunodeficiencies Outpatient Clinic, São Paulo University Medical School, S. Paulo, SP, Brazil.
Lismeia Raimundo
LR
Soares
Dermatology Department, Secondary Immunodeficiencies Outpatient Clinic, São Paulo University Medical School, S. Paulo, SP, Brazil.
Daniela Cardeal
DC
da Silva
Dermatology Department, Secondary Immunodeficiencies Outpatient Clinic, São Paulo University Medical School, S. Paulo, SP, Brazil.
Claudio R
CR
Gonsalez
Dermatology Department, Secondary Immunodeficiencies Outpatient Clinic, São Paulo University Medical School, S. Paulo, SP, Brazil.
Felipe G
FG
Batista
Preventive Medicine Department, São Paulo University Medical School, S. Paulo, SP, Brazil.
Luiz Augusto M
LA
Fonseca
Dermatology Department, Secondary Immunodeficiencies Outpatient Clinic, São Paulo University Medical School, S. Paulo, SP, Brazil.
Alberto J S
AJ
Duarte
Dermatology Department, Secondary Immunodeficiencies Outpatient Clinic, São Paulo University Medical School, S. Paulo, SP, Brazil.
Jorge
J
Casseb
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D059026:Diagnostic Self Evaluation; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D039682:HIV-Associated Lipodystrophy Syndrome / Q000175:diagnosis*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012959:Socioeconomic Factors; D049629:Waist-Hip Ratio
D019380:Anti-HIV Agents