[27] DXA ANALYSIS OF THE ASSOCIATION BETWEEN PROTEASE INHIBITOR USE AND FAT DISTRIBUTION IN HIV-INFECTED ADULTS

1st International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV

26–28 June 1999 - San Diego, CA, USA

DXA ANALYSIS OF THE ASSOCIATION BETWEEN PROTEASE INHIBITOR USE AND FAT DISTRIBUTION IN HIV-INFECTED ADULTS

Antiviral Therapy 1999; 4(Suppl. 2):48 (abstract no. 27)

A Shevitz, AY McDermott, T Knox, R Roubenoff, J Kehayias and S Gorbach
Tufts University School of Medicine, Boston, Massachusetts, USA

Abnormal body fat redistribution is being reported with increasing frequency in HIV-infected people, including increases in truncal girth and thinning of the extremities in men and women. These changes have been frequently, but not universally, associated with PI use. We examined whole body dual energy X-ray absorptiometry (DXA; Hologic QDR 2000) scans from 171 HIV-infected persons [135 men, 36 women; 48 black, 103 white, 11 hispanic, 9 other; mean age 41.5, (range 25-71); mean CD4 count 360 cells/mm³ (range 0-1140 cells/mm³); mean BMI 23.3 kg/m², (range 14.8-45.8 kg/m²); mean PI duration 12.6 months, (range 1-27 months); median 3.3 log₁₀ HIV RNA copies/ml, (range 2.3-6.0 log₁₀ HIV RNA copies/ml)]. In this cross-sectional analysis we compared total and regional body composition, with (n=101) or without PI use (n=70). After adjustment for weight, gender and age, people using PIs had significantly lower appendicular FM (-1.4 kg, P=0.003), but no significant differences in trunk fat mass (FM; +0.47 kg, P=0.32), weight (P=0.61), BMI (P=0.46), total FM (P=0.24), total lean mass (LM; P=0.24), or appendicular LM (P=0.65). After adjustment for total fat, persons using PIs had 0.97 kg more abdominal fat and 0.96 kg less extremity fat. Five percent less of total body fat was located in the extremities and 5% more of total body fat was located in the trunk among those using PIs; this was evident among both men and women. Therefore, regional DXA analysis demonstrated that PI use is associated with more trunk fat and less appendicular fat in men and women, without differences in total body composition or weight.

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