Multidisciplinary Approach to the Treatment of Metabolic and Morphologic Alterations of HIV-Related Lipodystrophy

Guaraldi, Giovanni; Orlando, Gabriella; Squillace, Nicola; G, De Santis; Pedone, Antonio; Spaggiari, Andrea; Fazio, Domenico De; Vandelli, Maria Angela; Paola, Maria De; Bertucelli, C.; Aldrovandi, Cristina; Nardini, Giulia; Beghetto, Barbara; Borghi, Vanni; Bertolotti, Marco; Bagni, B; Amorico, M. G.; Roverato, Alberto; Esposito, Roberto

doi:10.1310/eywj-8b5k-x7vq-9cpe

Cited by 50 publications

(45 citation statements)

References 23 publications

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“…Exercised HiV-infected individuals, regardless of the ending (lip ornolip), presented significant reduction of the thorax and waist measurements and increase of arm, forearm, thigh and calf measurements. Reduction in waist perimeter and WHR observed in the present study corroborates previous findings 27,28 , besides aiding in reducing the risk for cardiovascular disease 29 . On the other hand, our data show increase in waist perimeter and WHR only for the not exercised group with lipodystrophy, indicating hence that the sedentary condition added to lipodystrophy may contribute to the development of risk of cardiovascular disease 30 .…”

Section: Discussionsupporting

confidence: 92%

Treinamento físico para indivíduos HIV positivo submetidos à HAART: efeitos sobre parâmetros antropométricos e funcionais

Amorim

António

Oliveira

2013

Rev Bras Med Esporte

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INTRODUÇÃO: A terapia antirretroviral fortemente ativa (HAART) tem melhorado a prognose em indivíduos infectados pelo HIV. No entanto, a HAART tem sido associada ao desenvolvimento de anormalidades metabólicas e na distribuição de gordura corporal conhecida como síndrome lipodistrófica associada ao HIV (SLHIV). OBJETIVO: Este estudo investigou o impacto de 24 semanas de exercício resistido com componente aeróbico (ERCA) sobre parâmetros antropométricos e funcionais de portadores de HIV submetidos à HAART. MÉTODOS: Noventa e nove indivíduos infectados pelo HIV foram randomicamente alocados em quatro grupos: exercício e lipodistrofia (n = 24; EX+LIP); exercício sem lipodistrofia (n = 21; EX+NoLIP); controle e lipodistrofia (n = 27; NoEX+LIP); controle sem lipodistrofia (n = 27; NoEX+NoLIP). Os indivíduos dos grupos exercitados (EX+LIP e EX+NoLIP) participaram de 24 semanas de ERCA. Nos momentos pré e pós 24 semanas de intervenção foram realizadas medidas antropométricas, testes de força e aptidão cardiorrespiratória. RESULTADOS: Vinte e quatro semanas de ERCA alteraram os perímetros corporais avaliados (P < 0,0001) e a relação cintura/quadril (P = 0,017) nos dois grupos exercitados. Reduções foram observadas (P < 0,0001) para o somatório das sete dobras cutâneas avaliadas, percentual de gordura corporal, massa corporal gorda, gordura subcutânea total, central e periférica em resposta ao ERCA. A massa corporal magra aumentou (P < 0,0001) nos grupos exercitados, independente do desfecho (LIP ou NoLIP). A força muscular e a aptidão cardiorrespiratória aumentaram (P < 0,0001), para os dois grupos exercitados em resposta ao ERCA. CONCLUSÃO: Vinte e quatro semanas de ERCA impediram a manifestação das alterações decorrentes da SLHIV e contribuíram para a redução destas.

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Section: Discussionsupporting

confidence: 92%

Treinamento físico para indivíduos HIV positivo submetidos à HAART: efeitos sobre parâmetros antropométricos e funcionais

Amorim

António

Oliveira

2013

Rev Bras Med Esporte

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“…Interventions may involve acceptance of bodily changes, as well as nutrition counseling, exercise regimens, or surgery. 37,38 The current study has some limitations. The first is the small sample size, and the recruitment strategies may preclude findings from being generalizable to all populations of older, HIV-positive women.…”

Section: Discussionmentioning

confidence: 91%

Intimacy and Sexual Decision Making: Exploring the Perspective of HIV Positive Women Over 50

Psaros

Barinas

Robbins

et al. 2012

AIDS Patient Care and STDs

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Due to advances made in HIV treatment, the population of individuals with HIV over the age of 50 is growing. Aging women face many developmental challenges and some of these challenges, including having or maintaining intimate partner relationships, may be particularly pronounced for aging women living with HIV. However, research exploring the psychosocial needs of aging women with HIV is limited. Thus, the aim of this study was to explore factors that impact intimate partner relationships for older women with HIV. Nineteen women (mean age = 56.79, SD = 4.63 years) referred from Boston-area community organizations and hospitals completed in-depth individual interviews. Forty-seven percent of participants identified themselves as Black/ African American, and 37% as White/Caucasian. Average time since diagnosis was 16.32 years (SD = 5.70). Interviews continued until saturation of content was reached. Inclusion criteria included: biologically born female; aged 50 years or older; diagnosis of HIV/AIDS; and English speaking. Qualitative interviews were coded by two raters and content analyses were conducted using NVivo 9 software. The findings are described across the following three main themes: (1) stigma; (2) body image concerns; and (3) the disclosure dilemma. The themes and issues identified by this study may help guide sexual health-related interventions for older HIVinfected women.

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“…Some studies demonstrating effects have used instruments not widely validated in people with HIV infection, 8,9 while others have failed to find correlations with health-related quality of life. 10,11 The main objective of this study was to identify the impact of LD on the health-related quality of life in HIV-infected people taking HAART. The identification of the best instrument for the assessment of the impact of LD on the health-related quality of life could provide useful tools in clinical practice, both for monitoring the psychosocial effects of LD and evaluating outcomes of interventions to improve or preserve quality of life.…”

mentioning

confidence: 99%

Severity of Lipodystrophy Is Associated with Decreased Health-Related Quality of Life

Guaraldi

Murri

Orlando

et al. 2008

AIDS Patient Care and STDs

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The impact of lipodystrophy (LD) on quality of life is high, but it has not been demonstrated in literature. The objective of the study was to assess the impact of LD on the health-related quality of life (HRQOL) in HIV-infected people on highly active antiretroviral therapy (HAART). Patients with LD phenotype defined by the Multicenter AIDS Cohort Study (MACS) were included. Three different methods were used to define LD severity: both patient and physician evaluation using the HIV Outpatient Study (HOPS) severity scales and the Lipodystrophy Case Definition (LDCD). The HRQOL was evaluated by MOS-HIV Health Survey. Four hundred one patients on HAART for a mean of 108 Ϯ 52 months were evaluated for LD at the Metabolic Clinic of Modena and Reggio Emilia University were enrolled from January 2003 to July 2006. According to self-perceived or physician-based HOPS, 106 (26.5%) and 122 (30.4%) patients had severe LD. Females had significantly more severe LD. Few HRQOL scores correlated to LD severity using the physician-based score (both HOPSph and LDCD), while all the HRQOL scores correlated with LD severity when a patient-based score was used (HOPSpt). In multiple linear regression analysis, Mental Health HRQOL score, gender, body mass index, age, body image satisfaction were independent predictors of patient-based (HOPSpt) LD, while none of the HRQOL scores, but female gender, age, waist-to-hip ratio, limb fat, and body image satisfaction were correlated with physician-estimated HOPSph LD severity. HRQOL was strongly correlated with LD severity when a patientbased score was used. For an overall assessment of the impact of LD on HIV-infected people, both patientbased and physician-based measures are required. 577

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Multidisciplinary Approach to the Treatment of Metabolic and Morphologic Alterations of HIV-Related Lipodystrophy

Abstract: We conclude that the medical and surgical interventions proposed in this multidisciplinary therapeutic approach are efficacious and safe in the management of lipodystrophy.

Cited by 50 publications

References 23 publications

Treinamento físico para indivíduos HIV positivo submetidos à HAART: efeitos sobre parâmetros antropométricos e funcionais

Treinamento físico para indivíduos HIV positivo submetidos à HAART: efeitos sobre parâmetros antropométricos e funcionais

Intimacy and Sexual Decision Making: Exploring the Perspective of HIV Positive Women Over 50

Severity of Lipodystrophy Is Associated with Decreased Health-Related Quality of Life

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