Alterações metabólicas da síndrome lipodistrófica do HIV

Valente, Angelica; Reis, André; Machado, Daisy Maria; Succi, Regina Célia de Menezes; Chacra, Antônio Roberto

doi:10.1590/s0004-27302005000600004

Cited by 64 publications

(80 citation statements)

References 82 publications

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“…Clinically there are three patterns of body fat redistribution: (1) lipoatrophy: localized fat loss in the limbs, face and buttocks; (2) lipohypertrophy: central fat accumulation in the trunk, abdomen and posterior neck (buffalo hump); and (3) mixed pattern (lipoatrophy plus lipohypertrophy) [22]. Another sign that can be present is breast enlargement, both in men and in women [23].…”

Section: Body Fat Redistributionmentioning

confidence: 99%

“…Hyperinsulinemia and insulin resistance can occur as a result of therapy with PI or as a consequence of the HIV infection [22,30]. Initially, it was believed that the PI do not influence carbohydrate metabolism in prepubertal children, due to the higher insulin sensitivity observed in this phase [17].…”

Section: Insulin Resistancementioning

confidence: 99%

“…Lipodystrophic syndrome is more frequent in patients treated with PI, except for atazanavir, a new and potent PI not yet recommended for children [22,50]. Besides substituting traditional PI for atazanavir, other therapeutic options to attenuate dyslipidemia, insulin resistance and lipodistrophy include substitution of this PI with nevirapine (NNRTI), abacavir (NRTI), or efavirenz (NNRTI) [37,51].…”

Section: Antiretroviral Therapy Adjustmentmentioning

confidence: 99%

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Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

2008

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The introduction of highly active antiretroviral therapy (HAART) for the treatment of acquired immunodeficiency syndrome (AIDS) has resulted in greater survival of patients infected with the human immunodeficiency virus (HIV). However, the use of these drugs has been associated with lipodystrophic syndrome (LS), which is characterized by metabolic alterations (dyslipidemia, insulin resistance, diabetes, and lactic acidosis) and abnormal corporal fat distribution. Clinically, LS may manifest as three different forms: lipohipertrophy (accumulation of fat in the central part of the body), lipoatrophy (loss of fat in the extremities, face and buttocks) and mixed (lipohipertrophy + lipoatrophy). Although its physiopathology has not been elucidated, some mechanisms have been described, including leptin and adiponectin deficiency, mitochondrial dysfunction and use of antiretroviral drugs. The type, dose and duration of the antiretroviral treatment, as well as age and puberty are the main risk factors. LS is also associated with increased incidence of cardiovascular illnesses, atherosclerosis and diabetes mellitus. Treatment includes physical activity, cautious restriction of caloric intake, changes in antiretroviral therapy, and use of insulin-sensitizing and lipid-lowering agents. Follow up must be periodic, consisting of measurement of body fat distribution, evaluation of the lipid profile and insulin resistance.

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Section: Body Fat Redistributionmentioning

confidence: 99%

Section: Insulin Resistancementioning

confidence: 99%

Section: Antiretroviral Therapy Adjustmentmentioning

confidence: 99%

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Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

2008

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“…13 On the other hand, some studies suggest the participation of non-PI antiretrovirals [reverse transcriptase inhibitors analogous to nucleosides (NRTI)] in the common metabolic alterations among HIV/AIDS subjects, said to result in cardiovascular disease. 14 An increase in coronary events has also been observed in infected populations that have never used antiretrovirals, suggesting a direct effect of the virus itself on the atherogenic process 7 and/or individual exposure to smoking, hypertension, diabetes mellitus, dyslipidemia and traditionally recognized risk factors associated with the development of coronary atherosclerosis. 15 However, despite the above mentioned, the association of risk factors with atherosclerotic ischemic cardiopathy in these patients is still controversial.…”

Section: Introductionmentioning

confidence: 99%

Angina pectoris in patients with HIV/AIDS: prevalence and risk factors

Zirpoli¹,

Lacerda²,

Albuquerque³

et al. 2012

Braz J Infect Dis

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INTRODUCTION: The incidence of ischemic heart disease is higher in patients with HIV/AIDS. However, the frequency of angina pectoris in these patients is still not known. Literature about this subject is still scarce. OBJECTIVE: To evaluate the prevalence of angina pectoris and risk factors for coronary disease and to examine the association between traditional risk factors and HIV-related risk factors and angina pectoris. METHOD: An epidemiological cross-sectional study, analyzed as case-control study, involving 584 patients with HIV/AIDS. Angina pectoris was identified by Rose questionnaire, classified as definite or possible. Information regarding risk factors was obtained through a questionnaire, biochemical laboratory tests, medical records and anthropometric measures taken during consultations at AIDS treatment clinics in Pernambuco, Brazil, from June 2007 to February 2008. To adjust the effect of each factor in relation to others, multiple logistic regression was used. RESULTS: There was a preponderance of men (63.2%); mean ages were 39.8 years for men, 36.8 years for women. The prevalence of definite and possible angina were 11% and 9.4%, respectively, totaling 20.4%, with independent associations between angina and smoking (OR = 2.88; 95% CI: 1.69-4.90), obesity (OR = 1.62; 95% CI: 0.97-2.70), family history of heart attack (OR = 1.70; 95% CI: 1.00-2.88), low schooling (OR = 2.11; 95% CI: 1.24-3.59), and low monthly income (OR = 2.93; 95% CI: 1.18-7.22), even after adjustment for age. CONCLUSION: This study suggests that angina pectoris is underdiagnosed, even in patients with medical monitoring, revealing lost opportunities in identification and prevention of cardiovascular morbidity

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“…As mudanças corporais têm sido relacionadaa à lipohipertrofia (aparecimento de gordura dorsocervical, expansão da circunferência do pescoço, aumento do volume dos seios e acúmulo de gordura na região abdominal) e à lipoatrofia (diminuição de gordura periférica, com perda de tecido subcutâneo na face, braços, pernas e nádegas). A lipodistrofia também tem sido associada a alterações no metabolismo glicêmico, resistência insulínica e dislipidemia (Safrin & Grunfeld, 1999;Valente, Reis, Machado, Succi & Chacra, 2005).…”

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Bem-estar psicológico, enfrentamento e lipodistrofia em pessoas vivendo com HIV/AIDS

Seidl¹,

Machado²

2008

Psicol. estud.

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RESUMO.Os objetivos do estudo foram investigar os efeitos da lipodistrofia sobre o bem-estar psicológico e a adesão ao tratamento anti-retroviral, e identificar as estratégias de enfrentamento utilizadas por pessoas soropositivas afetadas pela síndrome. Participaram 21 pessoas, com idades entre 29 e 52 anos, das quais quatorze eram homens. As entrevistas foram analisadas com base na análise de conteúdo categorial. Os resultados apontaram que a descoberta e a vivência da lipodistrofia podem afetar o bem-estar psicológico, ocasionando redução da auto-estima, percepção negativa da imagem corporal e evitação de contatos sociais. Não se observou impacto negativo sobre a conduta de adesão. As estratégias de enfrentamento relatadas com maior freqüência foram: prática de atividade física, uso de roupas que escondam as mudanças corporais, realização de procedimentos estéticos e adoção de novos hábitos alimentares. Conclui-se que a ocorrência da lipodistrofia pode acarretar dificuldades psicológicas, merecendo atenção das equipes de saúde que atuam em HIV/aids.. Palavras-chave:pessoas vivendo com HIV/aids, lipodistrofia, bem-estar psicológico. PSYCHOLOGICAL WELL-BEING, COPING AND LIPODYSTROPHY IN HIV/AIDS PEOPLEABSTRACT. The study investigates the effects of the HIV lipodystrophy syndrome on the psychological well-being and on the adherence to anti-retroviral treatment. It also identifies the coping strategies used. Twenty-one people, age bracket 29 -52 years old, including fourteen males, took part in the research. Data procedures included structured and semi-structured interview. Results showed that disclosure of lipodystrophy may affect the psychological well-being, leading towards a decrease in self-esteem, negative perception of body image and avoidance of social relationships. The most related coping strategies consisted of practice of physical activities, usage of clothing which can hide body changes, realization of esthetic procedures and the adoption of new feeding habits. Results show that lipodystrophy experience may cause relevant emotional and psychological difficulties to affected people. This fact suggests that it should be given more attention to health professionals who deal with HIV/AIDS. Key words:Persons living with HIV/AIDS, lipodystrophy, psychological well-being. BIENESTAR PSICOLÓGICO, AFRONTAMIENTO Y LIPODISTROFIA EN PERSONAS QUE VIVEN CON VIH/SIDARESUMEN. Los objetivos del estudio fueron explorar los efectos de la lipodistrofia en el bienestar psicológico, la adhesión al tratamiento antirretroviral, bien como identificar las estrategias de afrontamiento utilizadas por personas soropositivas con lipodistrofia. Participaran de la investigación 21 personas, con edades entre 29 y 52 años, catorce hombres. El análisis de las entrevistas siguió la técnica de análisis de contenido categorial. Los resultados indican que la descubierta y vivencia de la lipodistrofia pueden afectan el bienestar psicológico, lo que ocasiona reducción en la autoestima, percepción negativa de la imagen corporal y evitación de ...

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Alterações metabólicas da síndrome lipodistrófica do HIV

Cited by 64 publications

References 82 publications

Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus

Angina pectoris in patients with HIV/AIDS: prevalence and risk factors

Bem-estar psicológico, enfrentamento e lipodistrofia em pessoas vivendo com HIV/AIDS

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