{"id":7877,"date":"2010-02-21T12:03:39","date_gmt":"2010-02-21T12:03:39","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=7877"},"modified":"2013-08-06T06:37:12","modified_gmt":"2013-08-06T06:37:12","slug":"central-fat-accumulation-remains-a-significant-problem-in-patients-starting-haart-after-2005-with-higher-incidence-in-women-compared-to-men","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/7877","title":{"rendered":"Central fat accumulation remains a significant problem in patients starting HAART after 2005 with higher incidence in women compared to men"},"content":{"rendered":"

Simon Collins, HIV\u00a0i-Base<\/strong><\/p>\n

A cross-sectional study from two large French hospitals presented at EACS was important for confirming that central fat accumulation (CFA), one of the symptoms associated with HIV-related lipodystrophy, remains a significant side effect, even for patients who have started treatment recently.<\/strong><\/p>\n

Isabelle Poizot-Martin and colleagues used waist circumference as a surrogate marker of CFA in 838 HIV-positive patients (71% male, 29% female) who\u00a0started combination antiretroviral therapy (cART) before (Group 1, n=723) or after January 2005 (Group 2, n=115). CFA was defined as >102\/88 cms (using\u00a0NCEP ATPIII guidelines) or >94\/80 cms (using IDF classification), for men\/women respectively.<\/p>\n

Median age (years) was 46 in Group 1 and 44 in Group 2 (p=0.004). Median CD4 count was 523 and 472 cells\/mm3, respectively (p=0.06) and viral load was\u00a0<40 copies\/mL in 84% of patients in each group. Exposure to cART was 11.6 vs 2.1 years for Group 1 and 2 respectively.<\/p>\n

CFA was reported in significantly higher rates for women compared to men in both groups, but also at higher rates in women who started treatment after\u00a02005 compared to women who started treatment earlier, as detailed in Table 1.<\/p>\n

Table 1: Percentages of patients with CFA diagnosed by waist circumference<\/strong><\/p>\n\n\n\n\n\n\n
<\/td>\nGroup
\n1<\/strong><\/td>\n		Group 1<\/strong><\/td>\nGroup 2<\/strong><\/td>\nGroup 2<\/strong><\/td>\n<\/tr>\n
NCEP<\/td>\nIDF<\/td>\nNCEP<\/td>\nIDF<\/td>\n<\/tr>\n
Men<\/td>\n12.7%<\/td>\n29.2%<\/td>\n11.8%<\/td>\n37.6 %<\/td>\n<\/tr>\n
Women<\/td>\n24.4%*<\/td>\n52.6%**<\/td>\n43.3%*<\/td>\n76.7%**<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

* p=0.028 ** p=0.013 (between group comparisons)<\/p>\n

While there were significant differences in use of different drugs in Group 1 compared to Groups 2 (mainly a higher use of triple-nucleoside regimens: by\u00a011 vs 2% of patients), there were no significant differences by sex, particularly for Group 2.<\/p>\n

COMMENT <\/strong><\/h3>\n

While further associations are limited in a single cross-sectional dataset, the conclusion that CFA remains highly prevalent in patients who\u00a0started treatment recently, is important. <\/strong><\/p>\n

The different rates of CFA in women compared to men had been previously reported and clearly warrant further study. The results support the
\nimportance for every new antiretroviral to include prospective monitoring of body fat changes within Phase 3 studies. It is difficult to understand how
\nany new drug could be approved without data on the impact it has on lipodystrophy and body fat changes.<\/strong><\/p>\n

Ref: Poizot-Martin I et al. Abdominal adiposity remains highly prevalent in French HIV-infected patients having initiated antiretroviral therapy after
\n2005. 12th EACS. 11-14 November 2009, Cologne. Abstract PS11\/1.<\/p>\n","protected":false},"excerpt":{"rendered":"

Simon Collins, HIV\u00a0i-Base A cross-sectional study from two large French hospitals presented at EACS was important for confirming that central fat accumulation (CFA), one of the symptoms associated with HIV-related lipodystrophy, remains a significant side effect, even for patients who …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,44,8,27],"tags":[72],"class_list":["post-7877","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-womens-health","category-side-effects","category-weight-diabetes-metabolic-complications","tag-eacs-12th-2009"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7877","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=7877"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/7877\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=7877"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=7877"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=7877"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}