Human immunodeficiency virus atropy induces modification of subcutaneous adipose tissue architecture:<i>in vivo</i>visualization by high-resolution magnetic resonance imaging

Josse, Gwendal; Gensanne, D.; Aquilina, C.; Bernard, Jacques; Saint-Martory, C.; Lagarde, Jean Michel; Schmitt, Anne-Marie

doi:10.1111/j.1365-2133.2008.08973.x

Cited by 5 publications

(3 citation statements)

References 23 publications

(51 reference statements)

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“…27 High resolution magnetic resonance made possible the identification of a clear disorganization of the adipose tissue of HIV positive patients and the alterations on the tissue architecture seem to appear earlier than the alterations detected by DEXA or clinical examination. 28 The ultrasound showed a moderate concordance between its findings and the lipoatrophy reported by the patient or the doctor at clinical evaluation. According to some authors, the anatomy of the face, the age of the patient and the quality of the skin interfere with the way how the subcutaneous fat is perceived exteriorly.…”

Section: Diagnosismentioning

confidence: 98%

Lipoatrofia facial associada ao HIV/AIDS: do advento aosconhecimentos atuais

Soares¹,

Costa

2011

An. Bras. Dermatol.

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Abstract:The advent of AIDS has brought new challenges to Dermatology. Antiretroviral therapy dramatically changed the morbidity and mortality associated with HIV / AIDS, but contributed to the emergence of other new situations that require adequate approach by the dermatologist. The HIV / AIDS Associated Lipodystrophy Syndrome is multifactorial in origin, but it is strongly associated with the use of antiretroviral drugs. It includes changes in body fat distribution, with or without metabolic changes. The loss of facial fat, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome. This condition, often revealing of the disease, brought back the stigma of AIDS. It is necessary that the specialists working with patients with HIV / AIDS identify these changes and seek treatment options, amongst which stands out the implant with polymethylmethacrylate, which is available for the treatment of HIV / AIDS facial lipoatrophy in the Brazilian Public Health System. Keywords: Ambulatory surgical procedures; HIV; HIV-associated lipodystrophy syndrome; Polymethyl methacrylate; Therapeutics Resumo: O advento da AIDS trouxe novos desafios para a Dermatologia. A terapia antirretroviral mudou drasticamente a morbimortalidade associada à infecção pelo HIV/AIDS, mas contribuiu para o surgimento de outras novas situações que exigem abordagem adequada do dermatologista. A Síndrome Lipodistrófica Associada ao HIV/AIDS tem origem multifatorial, mas está fortemente associada ao uso dos antirretrovirais. Compreende alterações na distribuição da gordura corporal, acompanhada ou não de alterações metabólicas. A perda da gordura da face, chamada lipoatrofia facial, é dos sinais mais estigmatizantes da síndrome. Esta condição, muitas vezes reveladora da doença, trouxe de volta o estigma da AIDS. É necessário que os especialistas que atuam com pacientes com HIV/AIDS identifiquem estas alterações e busquem opções de tratamento, dentre as quais se destaca o implante com polimetilmetacrilato, que é disponibilizado para tratamento da lipoatrofia facial associada ao HIV/AIDS no Sistema Único de Saúde.

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Section: Diagnosismentioning

confidence: 98%

Lipoatrofia facial associada ao HIV/AIDS: do advento aosconhecimentos atuais

Soares¹,

Costa

2011

An. Bras. Dermatol.

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“…It is also a source of great concern for patients as a result of stigmatization. The change in the amount and distribution of body fat must be considerable (loss of 30–50% of total body fat) before it becomes evident , and so cases of clinically obvious lipoatrophy are only the tip of the iceberg of a phenomenon that represents a generalized disorganization of the adipose tissue , starting when antiretrovirals (ARVs) are first used and continuing over time . When the patient perceives the change in his/her body shape, the fat loss is difficult to regain , and it is therefore important to prevent its appearance at a subclinical stage .…”

Section: Introductionmentioning

confidence: 99%

Impact of switching from zidovudine/lamivudine to tenofovir/emtricitabine on lipoatrophy: the RECOMB study

et al. 2013

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ObjectivesLipoatrophy is a long-term adverse effect of some antiretrovirals that affects quality of life, compromises adherence and may limit the clinical impact of HIV treatments. This paper explores the effect of tenofovir/emtricitabine (TDF/FTC) on the amount of limb fat in patients with virological suppression. MethodsA randomized, prospective clinical trial was performed to compare continuation on a zidovudine/lamivudine (ZDV/3TC)-based regimen with switching to a TDF/FTC-based regimen in terms of the effect on limb fat mass as assessed by DEXA over a 72-week period. ResultsEighty patients were included (39 in the TDF/FTC arm and 41 in the ZDV/3TC arm) and 73 completed the study (37 and 36, respectively). In the switch arm, limb fat increased by a median of 540 g from baseline (P = 0.022), while in the ZDV/3TC arm it decreased by a median of 379 g (P = 0.112; p between groups = 0.007). Subjects with baseline limb fat Յ 7200 g, previous time on ZDV > 5 years or a body mass index > 25 kg/m 2 experienced higher limb fat gains than other subjects, and these differences were statistically significant. Haemoglobin increased by a median of 1.0 g/dL in the TDF/FTC arm (P < 0.001) and remained unchanged in the ZDV/3TC arm (p between groups = 0.0002). There were no significant differences between groups in other secondary endpoints (body weight, total body and trunk fat content, total body bone mineral density, laboratory parameters, CD4 cell count and viral load). ConclusionsSwitching from a ZDV/3TC-based to a TDF/FTC-based regimen led to a statistically significant improvement in limb fat, in contrast to the progressive loss of limb fat in subjects continuing ZDV/3TC.

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“…MRI was performed on a Signa MR scan (General Electric, Milwaukee, USA) operating at 1.5 T, using a multi-spin-echo sequence (16 echoes) and a 60 mm diameter dedicated surface coil [7,8]. Images were acquired with a field of view of 50 mm 2 giving a resolution of 390 mm and a voxel size of 0.3 mm 3 with a 2 mm slice thickness.…”

mentioning

confidence: 99%

Follow up study of dermal hyaluronic acid injection by high frequency ultrasound and magnetic resonance imaging

Josse

Haftek

Gensanne

et al. 2010

Journal of Dermatological Science

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Human immunodeficiency virus atropy induces modification of subcutaneous adipose tissue architecture:in vivovisualization by high-resolution magnetic resonance imaging

Abstract: High-resolution MRI enabled visualization in vivo of precise changes in tissue organization due to HIV lipoatrophy. This imaging technique should be very informative for better monitoring of the atrophy.

Cited by 5 publications

References 23 publications

Lipoatrofia facial associada ao HIV/AIDS: do advento aosconhecimentos atuais

Lipoatrofia facial associada ao HIV/AIDS: do advento aosconhecimentos atuais

Impact of switching from zidovudine/lamivudine to tenofovir/emtricitabine on lipoatrophy: the RECOMB study

Follow up study of dermal hyaluronic acid injection by high frequency ultrasound and magnetic resonance imaging

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