Redistribution of body fat in HIV-infected women undergoing combined antiretroviral therapy

Gervasoni, Cristina; Ridolfo, Anna Lisa; Trifirò, Giuliana; Santambrogio, Sara; Norbiato, Guido; Musicco, Massimo; Clerici, Mario; Galli, Massimo; Moroni, Mauro

doi:10.1097/00002030-199903110-00004

Cited by 282 publications

(133 citation statements)

References 14 publications

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“…Likely reasons for the observed differences in our study and previous reports 6,11,12,15,17,21,23,24,[27][28][29][30]32 include our use of bidirectional questions to assess fat changes, our direct measurements of regional adipose tissue by MRI, and the comparison of HIV-infected and control women.…”

Section: Discussioncontrasting

confidence: 59%

“…However, our findings that upper trunk SAT and VAT was significantly higher in HIV-infected women without the clinical syndrome of peripheral lipoatrophy, who also had less leg SAT, may explain the previously proposed association of peripheral lipoatrophy with central lipohypertrophy. [11][12][13]15,17,18,20,21,23,24,[27][28][29][30] Interestingly, we found that in HIV-infected men, 37 VAT was similar between those with the clinical syndrome of peripheral lipoatrophy and those without the clinical syndrome of peripheral lipoatrophy. Although upper trunk SAT was higher in HIV-infected men without the clinical syndrome of peripheral lipoatrophy compared with those with the clinical syndrome, contrary to what we found in women, the amount of upper trunk SAT in both groups of HIV-infected men was less than in control men.…”

Section: Discussionmentioning

confidence: 95%

“…2,4,6,[10][11][12][13]15,20,25,[27][28][29][30] Studies have also used different definitions to define fat changes in HIV. Some defined fat changes as occurring in either peripheral or central body sites, [2][3][4]10,16,25,31 some combined both peripheral and central fat changes into 1 syndrome, [11][12][13]18,20,22,27,28 and others reported separately on lipoatrophy only, lipohypertrophy only, and "combined" syndromes. 15,17,21,23,24,29,30 Most studies used unidirectional questionnaires that presumed the presence of anticipated findings of peripheral lipoatrophy and central lipohypertrophy.…”

mentioning

confidence: 99%

“…15,17,21,23,24,29,30 Most studies used unidirectional questionnaires that presumed the presence of anticipated findings of peripheral lipoatrophy and central lipohypertrophy. 6,11,12,15,17,21,23,24,[27][28][29][30]32 Thus, there remains a debate about the definition of the syndrome. 1,15,17,20,24,29,30,[32][33][34] Early studies also did not include an HIV-uninfected comparison group.…”

mentioning

confidence: 99%

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Fat Distribution in Women With HIV Infection

2006

JAIDS Journal of Acquired Immune Deficiency Syndromes

113

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Objective-Both peripheral fat loss and central fat gain have been reported in women with HIV infection. We determined the fat changes that are specific to HIV infection in women.Methods-HIV-infected and control women from the study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM) were compared. Lipoatrophy or lipohypertrophy was defined as concordance between participant report of fat change and clinical examination. Whole-body magnetic resonance imaging measured regional adipose tissue volumes. The relationship among different adipose tissue depots was assessed. Factors associated with individual depots were analyzed using multivariate linear regression.Results-HIV-infected women reported more fat loss than controls in all peripheral and most central depots. Peripheral lipoatrophy was more frequent in HIV-infected women than controls (28% vs. 4%, P < 0.001), whereas central lipohypertrophy was similar (62% vs. 63%). Among HIV-infected women, those with central lipohypertrophy were less likely to have peripheral lipoatrophy (odds ratio, 0.39; 95% confidence interval, 0.20 to 0.75, P = 0.006) than those without central lipohypertrophy. On magnetic resonance imaging, HIV-infected women with clinical peripheral lipoatrophy had less subcutaneous adipose tissue (SAT) in peripheral and central sites and less visceral adipose tissue (VAT) than HIV-infected women without peripheral lipoatrophy. Compared with controls, HIV-infected women had less SAT in the legs, regardless of the presence or absence of lipoatrophy. However, those without lipoatrophy had more VAT and upper trunk SAT than controls. Use of the antiretroviral drug stavudine was associated with less leg SAT but was not associated with VAT. The use of highly active antiretroviral therapy, however, was associated with more VAT.Conclusions-Peripheral lipoatrophy occurs commonly in HIV-infected women but is not associated with reciprocally increased VAT or trunk fat.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Fat Distribution in Women With HIV Infection

2006

JAIDS Journal of Acquired Immune Deficiency Syndromes

113

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“…These include being pre-diabetic at the time of HIV infection [63], having other HIV related opportunistic diseases such as TB [64], and having elevated levels of glaciated haemoglobin [A1C] (Tien et al 2012); hence HIV alone is argued to be associated with a lower risk of DM at baseline [65]. These studies hold that other factors other than HIV infection alone influence the development of diabetes among PLHIV [66].…”

Section: Hiv and T2dmmentioning

confidence: 99%

The Effect of HIV and Art on the Development of Hypertension and Type 2 Diabetes Mellitus

Maseko¹,

Masuku²

2017

J Diabetes Metab

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Diabetes mellitus and hypertension [DM] are among the major causes of morbidity and mortality among people living with human immunodeficiency virus [PLHIV]. Diabetes mellitus alone is associated with morbidities that consequently reduce life expectancy and quality of life, and causes demoralising complications inclusive of ischaemic heart disease, stroke, blindness and peripheral vascular disease. Hypertension is an important and treatable cause of cardiovascular morbidity and mortality. It is an independent risk factor for myocardial infarction, chronic kidney disease ischemic and haemorrhagic stroke, heart failure and premature death. HIV infection is associated with morbidities that consequently reduce life expectancy and quality of life. There is a perceived link between HIV infection and DM and hypertension. This is a scoop review of studies on the link between HIV and DM and hypertension, that is, both epidemiologic and biological evidence to date. The literature review shows that the incidence and prevalence of type 2 diabetes [T2DM] is higher among PLHIV on ART compared to the HIV negative population. Being infected by human immunodeficiency virus (HIV) is implied to trigger an inflammatory response that, in turn, results in insulin resistance, a risk for T2DM. HIV is linked to hypertension through alterations in triglycerides, T cells and angiotensin II as well as the aggressive use of ART. The roll out of antiretroviral therapy (ART), as means to combat HIV, has benefits for PLHIV, inclusive of increased survival and living longer; yet older age is associated with hypertension and T2DM. The side effects of ART and long term use of ART are implicated in increasing the risk of T2DM among PLHIV. The co-occurrence of HIV, hypertension and T2DM in developing countries presents an overload to the burden of diseases because these countries are already experiencing high prevalence rates of HIV thereby complicating the health status of the population. Notwithstanding the contrasting research reports on the link between HIV, hypertension and DM hypertension and DM among PLHIV is a cause for concern, and there is a need for more studies, particularly in areas most hit by HIV.

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Adrenal Function in the Human Immunodeficiency Virus–Infected Patient

Mayo

Collazos²,

Martínez³

et al. 2002

Arch Intern Med

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Although clinical manifestations of adrenal dysfunction are uncommon in patients infected with human immunodeficiency virus (HIV), subclinical functional abnormalities of the hypothalamic-pituitary-adrenal axis are frequent. Patients infected with HIV usually have higher basal serum cortisol and lower serum dehydroepiandrosterone concentrations than HIV-seronegative individuals. This imbalance has been related to progression of the infection by inducing a shift from T(H)1 to T(H)2 immunologic responses. Although, adrenal reserve may be marginal in HIV-infected patients, clinically evident adrenal insufficiency is uncommon and, when present, it is observed in advanced stages of the infection. Hypocortisolemia should be treated regardless of the existence of associated symptoms. On the contrary, hypercortisolemia in the absence of features of Cushing syndrome is common and should not promote treatment nor specific studies. The possible influence that alterations of the adrenal function could have on the patients' immune status and the eventual effect of antiretrovirals on these alterations merit further investigation.

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Redistribution of body fat in HIV-infected women undergoing combined antiretroviral therapy

Cited by 282 publications

References 14 publications

Fat Distribution in Women With HIV Infection

Fat Distribution in Women With HIV Infection

The Effect of HIV and Art on the Development of Hypertension and Type 2 Diabetes Mellitus

Adrenal Function in the Human Immunodeficiency Virus–Infected Patient

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