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Pronounced lipoatrophy in HIV‐infected men receiving HAART for more than 6 years compared with the background population
Author(s) -
Hansen AB,
Lindegaard B,
Obel N,
Andersen O,
Nielsen H,
Gerstoft J
Publication year - 2006
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2005.00334.x
Subject(s) - medicine , lipodystrophy , trunk , triglyceride , lean body mass , population , lipoatrophy , endocrinology , metabolic syndrome , insulin , cholesterol , human immunodeficiency virus (hiv) , obesity , antiretroviral therapy , viral load , body weight , biology , immunology , ecology , environmental health
Objectives To establish the prevalence and quantify the severity of body fat redistribution and dyslipidaemia in HIV‐infected men after long‐term highly active antiretroviral therapy (HAART) compared with the background population. Methods In a cross‐sectional study, we included 87 HIV‐infected men who had received HAART for at least 6 years and 34 HIV‐negative men. Regional body composition was assessed using dual‐energy X‐ray absorptiometry. Fasting metabolic parameters were obtained. Associations between regional body fat distribution and metabolic parameters were evaluated. Results HIV‐infected patients and controls did not differ with regard to height and lean body mass. Compared with controls, HIV‐infected men had reduced total fat mass (median 12.3 versus 19.2 kg, P <0.001), limb fat mass (4.3 versus 7.9 kg, P <0.001), and trunk fat mass (6.7 versus 10.8 kg, P <0.001) and higher trunk/limb fat ratio (1.7 versus 1.2, P <0.001). Also, patients without clinical lipodystrophy had reduced amounts of limb and trunk fat. In HIV‐infected men, triglyceride levels were higher (2.0 versus 1.2 mmol/L, P <0.001), high‐density lipoprotein (HDL)‐cholesterol levels were lower (1.2 versus 1.3 mmol/L, P <0.05) and insulin levels were higher (40.8 versus 29.9 pmol/L, P <0.01) than in controls. All adverse metabolic parameters correlated with increased trunk/limb fat ratio, and insulin levels correlated positively with trunk fat mass ( P< 0.01). Conclusion Peripheral as well as central fat loss is a general characteristic of HIV‐infected men after long‐term HAART. Although lipoatrophy was the dominant morphological presentation, the adverse metabolic parameters were mainly associated with the increased ratio of trunk/limb fat.