title: People living with HIV on ART have accurate perception of lipodystrophy signs: a cross-sectional study.
abstract: BACKGROUND
  The prevalence of lipodystrophy ranges from 31 to 65%, depending on the criteria adopted for diagnosis. The usual methods applied in the diagnosis vary from self-perception, medical examination, skinfolds measurements, or even imaging assessment for confirmation of fat distribution changes. Although several methods have been developed, there is no gold standard for characterization of LA and LH, or mixed forms. This study aimed to compare self-reported signs of lipodystrophy with objective measures by skinfolds and circumferences, and to evaluate the prevalence of lipoatrophy (LA) and lipohypertrophy (LH) among subjects living with HIV/AIDS on ART.
  
  
  METHODS
  A cross-sectional study enrolled participants living with HIV/AIDS receiving ART, aged 18 years or older from an outpatient health care center, in Southern Brazil. Self-reported body fat enlargement in the abdomen, chest or breasts, and dorsocervical fat pad were used to determine LH, while LA was identified by self-reported fat wasting of the face, neck, legs, arms or buttocks. Measurements were obtained with a scientific caliper for infraorbital, buccal, and submandibular skinfolds, and using an inelastic tape to measure circumferences of waist, hip, neck, and arm. LH and LA were established by the presence of at least one self-reported sign.
  
  
  RESULTS
  Comparisons of self-reported signs with objective measurements for men and women were carried out in 815 participants on ART, out of 1240 participants with HIV infection. Self-report of decreased facial fat and sunken cheeks was associated with lower infraorbital, buccal, and submandibular skinfolds. Participants who reported buffalo hump had, on average, greater neck circumference, as well as those who have increased waist circumference also reported abdominal enlargement, but no buttock wasting. Men were most commonly affected by lipoatrophy (73 vs. 53%; P < 0.001), and women by lipohypertrophy (79 vs. 56%; P < 0.001).
  
  
  CONCLUSIONS
  In conclusion, self-reported signs of lipodystrophy and lipoatrophy are prevalent, differ by gender, and are associated with objective measurements in people living with HIV/AIDS.
authors.affiliation: Hospital Sanatório Partenon, State Department of Health, Rio Grande do Sul. Av. Bento Gonçalves, 3722, Porto Alegre, RS, 90650-001, Brazil.|Post-graduate Program of Collective Health, Universidade do Vale do Rio dos Sinos, Av. Unisinos, 950, São Leopoldo, RS, 93022-750, Brazil.
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Alencastro
authors.affiliation: Post-graduate Program of Collective Health, Universidade do Vale do Rio dos Sinos, Av. Unisinos, 950, São Leopoldo, RS, 93022-750, Brazil.
authors.forename: Nemora T
authors.initials: NT
authors.lastname: Barcellos
authors.affiliation: Postgraduate Studies Program in Sciences in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, Porto Alegre, RS, 90035-003, Brazil.
authors.forename: Fernando H
authors.initials: FH
authors.lastname: Wolff
authors.affiliation: Post-graduate Program of Collective Health, Universidade do Vale do Rio dos Sinos, Av. Unisinos, 950, São Leopoldo, RS, 93022-750, Brazil.|Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, Porto Alegre, RS, 90035-003, Brazil.
authors.forename: Maria Letícia R
authors.initials: ML
authors.lastname: Ikeda
authors.affiliation: Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, Porto Alegre, RS, 90035-003, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Schuelter-Trevisol
authors.affiliation: Post Graduate Studies Program in Medicine-Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, RS, 90050-170, Brazil.
authors.forename: Ajácio B M
authors.initials: AB
authors.lastname: Brandão
authors.affiliation: Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos 2600, Porto Alegre, RS, 90035-003, Brazil. scfuchs@terra.com.br.|Division of Cardiology, Centro de Pesquisa Clínica, 5º andar, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcellos, 2350, Porto Alegre, RS, 90035-903, Brazil. scfuchs@terra.com.br.
authors.forename: Sandra C
authors.identifier: http://orcid.org/0000-0001-6351-9588
authors.initials: SC
authors.lastname: Fuchs
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001828:Body Image; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008060:Lipodystrophy / Q000523:psychology*; D008297:Male; D008875:Middle Aged
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; HIV; Lipoatrophy; Lipodystrophy; Lipohypertrophy