Objectives: In long-term HIV-infected patients, peripheral lipoatrophy (LA) and central lipohypertrophy (LH) appear to be related to the same insults (virus and antiretroviral drugs), but are likely to be associated with different fat depot physiologies. The objective of this study was to describe the natural history of lipodystrophy assessed using dual energy X-ray absorptiometry (DEXA) and computed tomography (CT) in a large HIV out-patients metabolic clinic. Methods: An observational retrospective study was carried out including HIV-infected patients recruited at the Metabolic Clinic of Modena, Modena, Italy, who were assessed for lipodystrophy and had at least two anthropometric evaluations using DEXA for leg fat per cent mass and abdominal CT for visceral adipose tissue (VAT). Factors associated with leg fat per cent and VAT changes were analysed using multivariable generalized estimating equation (GEE) regression models. Results: A total of 6789 DEXAs and 7566 CT scans were evaluated in the observation period. A total of 1840 patients were included; the mean age was 45.2±7.2 (standard deviation) years, 621 (34%) were women, and the median HIV infection duration was 176 (interquartile range 121-232) years. According to the GEE multivariable regression analysis, leg fat per cent evaluated with DEXA appeared to increase over calendar years (ß=0.92; P<0.001); moreover, a progressive increase in VAT was observed in the cohort (ß=5.69; P<0.001). No association with antiretroviral drugs was found. Conclusions: In our study, neither LA nor LH appeared to be associated with antiretroviral drug exposure. We observed a progressive increase in LH in HIV-infected patients over calendar years. This anthropometric change, together with loss of appendicular lean mass, could describe a physiological aging process in HIV-infected patients.

The natural history of HIV-associated lipodystrophy in the changing scenario of HIV infection / Guaraldi, Giovanni; Stentarelli, Chiara; Zona, Stefano; A., Santoro; Beghetto, Barbara; Carli, Federica; Orlando, Gabriella; Franceschetto, Antonella; A., Casolo; Mussini, Cristina. - In: HIV MEDICINE. - ISSN 1464-2662. - STAMPA. - 15(10):(2014), pp. 587-594. [10.1111/hiv.12159]

The natural history of HIV-associated lipodystrophy in the changing scenario of HIV infection

GUARALDI, Giovanni;STENTARELLI, Chiara;ZONA, Stefano;BEGHETTO, Barbara;CARLI, FEDERICA;ORLANDO, Gabriella;FRANCESCHETTO, Antonella;MUSSINI, Cristina
2014

Abstract

Objectives: In long-term HIV-infected patients, peripheral lipoatrophy (LA) and central lipohypertrophy (LH) appear to be related to the same insults (virus and antiretroviral drugs), but are likely to be associated with different fat depot physiologies. The objective of this study was to describe the natural history of lipodystrophy assessed using dual energy X-ray absorptiometry (DEXA) and computed tomography (CT) in a large HIV out-patients metabolic clinic. Methods: An observational retrospective study was carried out including HIV-infected patients recruited at the Metabolic Clinic of Modena, Modena, Italy, who were assessed for lipodystrophy and had at least two anthropometric evaluations using DEXA for leg fat per cent mass and abdominal CT for visceral adipose tissue (VAT). Factors associated with leg fat per cent and VAT changes were analysed using multivariable generalized estimating equation (GEE) regression models. Results: A total of 6789 DEXAs and 7566 CT scans were evaluated in the observation period. A total of 1840 patients were included; the mean age was 45.2±7.2 (standard deviation) years, 621 (34%) were women, and the median HIV infection duration was 176 (interquartile range 121-232) years. According to the GEE multivariable regression analysis, leg fat per cent evaluated with DEXA appeared to increase over calendar years (ß=0.92; P<0.001); moreover, a progressive increase in VAT was observed in the cohort (ß=5.69; P<0.001). No association with antiretroviral drugs was found. Conclusions: In our study, neither LA nor LH appeared to be associated with antiretroviral drug exposure. We observed a progressive increase in LH in HIV-infected patients over calendar years. This anthropometric change, together with loss of appendicular lean mass, could describe a physiological aging process in HIV-infected patients.
2014
15(10)
587
594
The natural history of HIV-associated lipodystrophy in the changing scenario of HIV infection / Guaraldi, Giovanni; Stentarelli, Chiara; Zona, Stefano; A., Santoro; Beghetto, Barbara; Carli, Federica; Orlando, Gabriella; Franceschetto, Antonella; A., Casolo; Mussini, Cristina. - In: HIV MEDICINE. - ISSN 1464-2662. - STAMPA. - 15(10):(2014), pp. 587-594. [10.1111/hiv.12159]
Guaraldi, Giovanni; Stentarelli, Chiara; Zona, Stefano; A., Santoro; Beghetto, Barbara; Carli, Federica; Orlando, Gabriella; Franceschetto, Antonella; A., Casolo; Mussini, Cristina
File in questo prodotto:
File Dimensione Formato  
2014_The natural history of HIV.pdf

Accesso riservato

Tipologia: Versione pubblicata dall'editore
Dimensione 164.61 kB
Formato Adobe PDF
164.61 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1017722
Citazioni
  • ???jsp.display-item.citation.pmc??? 16
  • Scopus 24
  • ???jsp.display-item.citation.isi??? 26
social impact