Risk of lipodystrophy in HIV-positive treated with PIs: a prospective cohort study

Researchers completed a study of antiretroviral-naive HIV-positive patients in an effort to identify the risk factors for developing lipodystrophy while undergoing highly aggressive antiretroviral therapy (HAART).

Evidence of moderate to severe body-fat changes were clinically assessed and categorized as subcutaneous lipoatrophy, central obesity, or both, in adults who were undergoing HAART with two nucleoside reverse transcriptase inhibitors plus at least one protease inhibitor.

After 18 months of follow-up, 17 percent of nearly 500 patients exhibited lipodystrophy; that figure increased to 23 percent after 24 months. The findings agreed with earlier studies which found that patients diagnosed with any lipodystrophy exhibited an increase in their CD4-lymphocyte count, a greater decrease in viral load, and a greater increase in triglycerides and cholesterol in comparison to patients who do not develop lipodystrophy.

The researchers had hoped that their study would be able to isolate the specific risk factors, but instead the scientists had to conclude that the factors were too multifactorial and overlapping and could not be exclusively attributed to exposure to any one specific antiretroviral agent.

Martinez E; Morcroft A; Garcia-Viejo MA et al. Lancet (24/02/01) Vol. 357, No. 9256, P. 592.