Fat Redistribution in Indinavir-Treated Patients With HIV Infection: A Review of Postmarketing Cases

Benson, Joan O.; McGhee, Kay; Coplan, Paul; Grünfeld, Carl; Robertson, Michael; Brodovicz, Kimberly G.; Slater, Eve E.

doi:10.1097/00042560-200010010-00007

Cited by 16 publications

(6 citation statements)

References 19 publications

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“…As mentioned previously, although there seems to be fat redistribution associated with protease inhibitor therapy (Benson et al, 2000;Hadigan et al, 2000;McDermott et al, 2001), there is not necessarily a change in the amount of body fat, and therefore BIA may not be a sensitive method for finding these changes (Gerrior, Kantaros, Coakley, Albrecht, & Wanke, 2001;Schwenk et al, 2001). We did not collect data on how long any subject had been taking antiretroviral medication, and this may be useful information to collect for future studies on body composition in HIV-positive people.…”

Section: Discussionmentioning

confidence: 96%

Bioimpedance analysis and HIV-related fatigue

Meynell¹,

Barroso²

2005

Journal of the Association of Nurses in AIDS Care

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Although various physiological and psychological causes of fatigue in HIV-positive persons have been proposed, it is still not well understood. Bioimpedance analysis has proved to be an easily used, non-invasive measurement of body composition and cellular integrity. This study, looking at whether body composition as measured by bioimpedance analysis is associated with fatigue, is part of a pilot study looking for physiological and psychological biomarkers that could be factors in the fatigue experienced by HIV-positive people. Twenty-nine men and eleven women were measured for height, weight, and bioimpedance analysis. Correlations were examined between fatigue intensity and weight, body mass index, body cell mass, fat-free mass, extracellular mass, and phase angle. Because of the fat redistribution that has occurred with some people taking protease inhibitors, we also examined differences in weight, body mass index, body cell mass, fat-free mass, and fatigue intensity between those taking and those not taking protease inhibitors. There was no association between fatigue intensity and weight, body mass index, body cell mass, fat-free mass, or phase angle, nor were there differences between those taking and those not taking protease inhibitors. However, it was noted that both the phase angle and the ratio of extracellular mass to body cell mass (extracellular mass:body cell mass) were below their respective normal ranges, indicating that the participants were somewhat compromised nutritionally and with regard to cell membrane integrity. Although fatigue was not shown to be related to body composition measurement in this study, further work is needed on the causes of fatigue, because its effects on the lives of HIV-positive people can be devastating.

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Section: Discussionmentioning

confidence: 96%

Bioimpedance analysis and HIV-related fatigue

Meynell¹,

Barroso²

2005

Journal of the Association of Nurses in AIDS Care

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“…NRTIs are strongly associated with the loss of subcutaneous fat and hyperlactatemia, while PIs are more closely associated with lipoaccumulation and effects on lipid metabolism and insulin resistance. The effects of NRTIs appear to be augmented or accelerated when combined with PIs (49,50), and the manifestations of lipodystrophy are different than in patients receiving NRTIs alone (49,51). NRTIs in combination with PIs result in a greater increase in VAT, hyperinsulinemia, insulin resistance and dyslipidemia.…”

Section: Treatment Factorsmentioning

confidence: 99%

HIV‐associated Lipodystrophy Syndrome: A Review of Clinical Aspects

Baril

Junod

LeBlanc

et al. 2005

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Approximately two years after the introduction of highly active antiretroviral therapy for the treatment of HIV infection, body shape changes and metabolic abnormalities were increasingly observed. Initially, these were ascribed to protease inhibitors, but it is now clear that nucleoside reverse transcriptase inhibitors also contribute to lipodystrophy syndrome. The syndrome groups together clinical conditions describing changes in body fat distribution that include lipoatrophy, lipoaccumulation or both. However, there does not appear to be a direct link between lipoatrophy and lipoaccumulation that would support a single mechanism for the redistribution of body fat. Currently, there is no clear definition of lipodystrophy, which explains the difficulty in determining its prevalence and etiology. There are no current guidelines for the treatment of fat distribution abnormalities that occur in the absence of other metabolic complications. The present article reviews the current state of knowledge of the definition, symptoms, risk factors, pathogenesis, diagnosis and treatment of the morphological changes associated with lipodystrophy syndrome.

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“…Different studies have agreed on the association of lipohypertrophy with PIcontaining therapies, age, female gender, high viral load, ART duration, and elevated body mass index and also relate the development of lipoatrophy to a low body mass index, estavudine treatment, severity and duration of HIV infection and/or >2 years of treatment with indinavir [5,9,11,22,25,33]. These factors could be directly implicated or associated with other environmental factors like diet, physical exercise and genetics, whose influence is as yet unknown.…”

Section: Introductionmentioning

confidence: 99%