Prevalence of obesity and its relationship to clinical lipodystrophy in HIV-infected adults on anti-retroviral therapy

• Published in: Journal of endocrinological investigation 2012-12, Vol.35 (11), p.964-970
• Main Authors: Freitas, P., Carvalho, D., Santos, A. C., Matos, M. J., Madureira, A. J., Marques, R., Martinez, E., Sarmento, A., Medina, J. L.
• Format: Article
• Language: English
• Subjects: Anti-HIV Agents - therapeutic use; Body Composition; Body Mass Index; CD4 Lymphocyte Count; Cross-Sectional Studies; Endocrinology; Female; HIV-1 - isolation & purification; HIV-Associated Lipodystrophy Syndrome - complications; HIV-Associated Lipodystrophy Syndrome - drug therapy; Humans; Logistic Models; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Obesity - virology; Original Articles; Portugal; RNA, Viral - blood; Waist Circumference; Waist-Hip Ratio
• ISSN: 0391-4097; 1720-8386
• DOI: 10.3275/8187

Background: Combination antiretroviral therapy (cART) is associated with lipodystrophy (lipoatrophy and lipoaccumulation) and several metabolic abnormalities that together can contribute to an increased cardiovascular risk. The aim of this study was to evaluate the prevalence of obesity in patients on cART according to the presence of clinical lipodystrophy (CL) and to analyze factors associated with obesity. Methods: We evaluated 368 HIV-infected adults on cART. Results: CL was present in 59.0%. Independently of gender, patients with CL were more frequently underweight [5.7% (21/368)] and of normal weight [47.3% (174/368)], and less frequently overweight [33.2% (122/368)] or obese [13.9% (51/368)]. Mean body mass index was higher in patients with abdominal prominence regardless of the presence of clinical lipoatrophy. Patients with CL had lower waist circumference, higher waist/hip and fat mass ratio and lower total and subcutaneous fat, without significant difference in visceral fat but with a higher visceral/subcutaneous fat ratio, as evaluated by CT at abdominal level. CL was significantly less frequent in overweight [odds ratio (OR)=0.21, 95% confidence interval (CI): 0.05–0.92] and obese (OR=0.05, 95%CI: 0.01–0.26) patients, when compared to underweight ones, independent of age, gender, duration of infection, cART regimen, virological suppression, and HIV-infection risk factor. Conclusions: Being overweight or obese is highly prevalent in HIV-infected patients on cART. Patients with CL were more frequently under- or normal weight, and less frequently overweight or obese. Obesity is a condition that should be considered in HIV patients on cART.