Naslov
Reversibility of lipoatrophy in HIV-infected patients taking antiretroviral therapy: a cohort study with ultrasound assessment

Autori
Begovac, Josip ; Šoštarić Zadro, Ana ; Lukas, Davorka ; Višković, Klaudija

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
1st South-East European Conference on Travel, Tropical, Migration Medicine and HIV & 2nd Croatian Congress on Travel, Tropical, Migration Medicine & HIV

Mjesto i datum
Dubrovnik, Hrvatska, 28.09.2017. - 01.10.2017

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
Lipoatrophy ; HIV-infected patients ; antiretroviral therapy ; ultrasound

Sažetak
Background: Older antiretroviral drugs such as stavudine and zidovudine have been associated with lipoatrophy. Ultrasound (US) imaging has the advantage of low cost, wide availability, repeatability, safety and has been utilized in the quantitative estimation of subcutaneous fat loss. We conducted a longitudinal study to compare the reversibility of lipoatrophy as measured by US over an at least five-year period and examined factors related to this revertability. Methods: Participants were consecutively recruited and enrolled over a 15-month period beginning in July 2006. We included all patients older than 18 years and at least 1-year duration of antiretroviral therapy. We performed sonographic measurements of the malar, brachial and crural area at two time point on average (median) 7 years apart in 77 persons. Sonographic measurements were done using a linear array probe (10 MHz and 42 mm) in supine position. The primary outcome variables were the change in the thickness of the subcutaneous fat on the malar, brachial and crural region. A 14-point food-items questionnaire was used to assess adherence to the traditional Mediterranean diet. The Wilcoxon signed-rank test was used to compare measurements at two-time points. Results: There was evidence of increase in the subcutaneous malar area and no increase in the brachial and crural area. This increase coincided with stopping stavudine and fewer patients receiving zidovudine. Of 46 persons who ever used stavudine none of them received it at the second visit. Of 58 persons who ever used zidovudine, 16 received it on the second visit. However, the increase in the malar area was modest, on average 3.8 mm in the 7-year period. We also found evidence that no current use of efavirenz could be associated with a greater increase in subcutaneous malar fat area (P=0.010). A life style with non- adherence to the Mediterranean diet and smoking was associated with a smaller increase in subcutaneous malar fat (P=0.014). Conclusions: There was no or only a modest increase in subcutaneous fat in the relatively long follow-up period. In addition to drugs well known to affect subcutaneous fat (stavudine, zidovudine), treatment with efavirenz and life style factors such as adherence to the Mediterranean diet and smoking could contribute to the change in subcutaneous fat.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA