Clinical assessment of HIV-associated lipodystrophy in an ambulatory population

Lichtenstein, Kenneth A.; Ward, Douglas J.; Moorman, Anne C.; Delaney, Kathleen M.; Young, Benjamin; Palella, Frank J.; Rhodes, Philip; Wood, Kathy; Holmberg, Scott D.

doi:10.1097/00002030-200107270-00008

Cited by 386 publications

(352 citation statements)

References 12 publications

Supporting

Mentioning

308

Contrasting

Unclassified

Order By: Relevance

“…This study revealed that the prevalence of lipoatrophy in HIV-infected Koreans receiving HAART is not uncommon and was within the range of that reported in other studies (Lichtenstein et al 2001;Paton et al 2002;Bacchetti et al 2005;Jacobson et al 2005;Pujari et al 2005;Waters and Nelson 2007). The previous studies performed in single institute of Asia including South Korea, Singapore, India and Thailand reported the percentage of HIV-infected patients with peripheral fat loss as very wide range from 3.5% to 62.5% (Chang et al 2002;Paton et al 2002;Pujari et al 2005;Chuapai et al 2007).…”

Section: Discussionsupporting

confidence: 85%

“…However, many studies reported the prevalence and risk factors of lipodystrophy in general, not lipoatrophy specifically (Waters and Nelson 2007). Previous cross-sectional studies, which were performed in continents outside Asia, revealed that the prevalence of lipoatrophy ranged between 13 and 38% (Lichtenstein et al 2001;Bacchetti et al 2005;Jacobson et al 2005;Waters and Nelson 2007). In 2002, Chang et al reported that lipodystrophy was observed in only 2 (3.5%) of 57 HIV-infected Koreans receiving HAART and metabolic complications of HAART were rare (Chang et al 2002).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of and Clinical Factors Associated with Lipoatrophy in HIV-Infected Koreans Receiving Highly Active Antiretroviral Therapy

Han

Chin

Choi

et al. 2009

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 99%

Prevalence of and Clinical Factors Associated with Lipoatrophy in HIV-Infected Koreans Receiving Highly Active Antiretroviral Therapy

Han

Chin

Choi

et al. 2009

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

“…Inclusion criteria The HIV-infected women had a physician-confirmed diagnosis of lipodystrophy according to the HIV Outpatients Study definition (24), with or without metabolic alterations; they had documented HIV infection for more than 5 years and were receiving HAART for least 6 months.…”

Section: Subjectsmentioning

confidence: 99%

GH response to GHRH plus arginine is impaired in lipoatrophic women with human immunodeficiency virus compared with controls

Zirilli

Orlando

Carli

et al. 2012

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: GH secretion is impaired in lipodystrophic human immunodeficiency virus (HIV) patients and inversely related to lipodystrophy-related fat redistribution in men. Less is known about the underlying mechanisms involved in reduced GH secretion in HIV-infected women. Design: A case-control, cross-sectional study comparing GH/IGF1 status, body composition, and metabolic parameters in 92 nonobese women with HIV-related lipodystrophy and 63 healthy controls matched for age, ethnicity, sex, and body mass index (BMI). Methods: GH, IGF1, IGF binding protein 3 (IGFBP3), GH after GHRH plus arginine (GHRHCArg), several metabolic variables, and body composition were evaluated. Results: GH response to GHRHCArg was lower in HIV-infected females than in controls. Using a cutoff of peak GH %7.5 mg/l, 20.6% of HIV-infected females demonstrated reduced peak GH response after GHRHCArg. In contrast, none of the control subjects demonstrated a peak GH response %7.5 mg/l. Bone mineral density (BMD), quality of life, IGF1, and IGFBP3 were lowest in the HIV-infected females with a GH peak %7.5 mg/l. BMI was the main predictive factor of GH peak in stepwise multiregression analysis followed by age, with a less significant effect of visceral fat in the HIV-infected females. Conclusions: This study establishes that i) GH response to GHRHCArg is lower in lipoatrophic HIVinfected women than in healthy matched controls, ii) BMI more than visceral adipose tissue or trunk fat influences GH peak in this population, and iii) HIV-infected women with a GH peak below or equal to 7.5 mg/l demonstrate reduced IGF1, IGFBP3, BMD, and quality of life.

show abstract

“…The degree of lipoatrophy at each of seven regions was rated using the HIV Outpatient Study (HOPS) scale, which was categorised as follows: absent (score of 0); mild (noticeable on close inspection; score of 1); moderate (readily noticeable by patient or physician; score of 2); or severe (readily noticeable to a casual observer; score of 3). 21 The impact of body habitus changes on the manner in which the patient's clothes fit was also noted. Patients with suspected lipoatrophy were carefully examined by an experienced physician, with further investigations if needed to rule out mimicking conditions such as treatment failure or new opportunistic infections.…”

Section: Art Eligibility Regimens and Treatment Monitoringmentioning

confidence: 99%

Weight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, Rwanda

Griensven

Zachariah

Mugabo

et al. 2010

Transactions of the Royal Society of Tropical Medicine and Hygi

View full text Add to dashboard Cite

CitationWeight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, Rwanda. 2010, 104 (12) a b s t r a c tThis study was conducted among 609 adults on stavudine-based antiretroviral treatment (ART) for at least one year at health center level in Kigali, Rwanda to (a) determine the proportion who manifest weight loss after one year of ART (b) examine the association between such weight loss and a number of variables, namely: lipoatrophy, virological failure, adherence and on-treatment CD4 count and (c) assess the validity and predictive values of weight loss to identify patients with lipoatrophy. Weight loss after the first year of ART was seen in 62% of all patients (median weight loss 3.1 kg/year). In multivariate analysis, weight loss was significantly associated with treatment-limiting lipoatrophy (adjusted effect/kg/year -2.0 kg, 95% confidence interval -0.6;-3.4 kg; P < 0.01). No significant association was found with virological failure or adherence. Higher on-treatment CD4 cell counts were protective against weight loss. Weight loss that was persistent, progressive and/or chronic was predictive of lipoatrophy, with a sensitivity and specificity of 72% and 77%, and positive and negative predictive values of 30% and 95%. In low-income countries, measuring weight is a routine clinical procedure that could be used to filter out individuals with lipoatrophy on stavudine-based ART, after alternative causes of weight loss have been ruled out.

show abstract

Clinical assessment of HIV-associated lipodystrophy in an ambulatory population

Cited by 386 publications

References 12 publications

Prevalence of and Clinical Factors Associated with Lipoatrophy in HIV-Infected Koreans Receiving Highly Active Antiretroviral Therapy

Prevalence of and Clinical Factors Associated with Lipoatrophy in HIV-Infected Koreans Receiving Highly Active Antiretroviral Therapy

GH response to GHRH plus arginine is impaired in lipoatrophic women with human immunodeficiency virus compared with controls

Weight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, Rwanda

Contact Info

Product

Resources

About