Lipodystrophy and Metabolic Disorders in HIV-1-Infected Adults on 4- to 9-Year Antiretroviral Therapy in Senegal: A Case-Control Study

• DOI: 10.1097/qai.0b013e31819c16f4
• Publication Date: 2009-05-21T12:35:47Z
• Authors: Sabine Mercier; Ndeye Fatou Ngom ...; Amandine Cournil; Annick Fontbonne; Nane Copin; Ibrahima Ndiaye; Anne-Marie Dupuy; Cécile Cames; Papa Salif Sow; Ibra Ndoye; Eric Delaporte; Kirsten Bork Simo...
• Keywords: Lipodystrophy; Stavudine; Lipoatrophy; Waist–hip ratio

Objective: To assess adverse effects of long-term highly active antiretroviral therapy (HAART), that is, lipodystrophy and metabolic disorders, in a cohort African patients. Methods: One hundred eighty HIV-1-infected patients treated with HAART for 4-9 years Dakar 180 age-matched sex-matched controls were enrolled. Regional subcutaneous fat changes assessed by physicians, fasting blood samples drawn. Centralization body was estimated using skinfold ratio, waist circumference, to hip ratio (WHR). Results: Mean duration 5.4 years. Main drugs received zidovudine, stavudine, protease inhibitors. The prevalence moderate-severe 31.1% (95% confidence interval: 24.3 37.9), 13.3%, 14.5%, 3.3% lipoatrophy, lipohypertrophy, mixed forms, respectively. Mild-severe affected 65.0% (58.0; 72.0) Stavudine the only independent risk factor (any vs. none: odds = 2.8; 1.4 5.5). Patients had lower mass index skinfolds but greater centralization (WHR, P < 0.0001 0.001), glucose (P 0.0001), homeostasis model assessment insulin resistance, triglyceride levels 0.01 both) than controls. Moderately-severely lipodystrophic higher low-density lipoprotein cholesterol other 0.001 0.05, respectively). Conclusions: Moderate-severe one third West on associated less favorable profile.