AEGiS-15IAC: HIV-associated lipodystrophy in Thailand: The prevalence clinical characteristic and metabolic consequence.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

HIV-associated lipodystrophy in Thailand: The prevalence clinical characteristic and metabolic consequence.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10413)

Puttawong S, Prasithsirikul W, Vadcharavivad S
Bamrasnaradura Infectious Disease Institute, Nonthaburi, Thailand

BACKGROUND: HIV-associated lipodystrophy syndrome(LD) is a recently recognized syndrome characterized by morphologic and metabolic changes observed during antiretroviral therapy(ART). The morphologic change can be highly stigmatizing and the metabolic manifestation may contribute to a range of morbidities. The objective of this study to determine the prevalence and clinical characteristic of LD in HIV infected Thai patients who either did or did not receive ART and study ART pattern in LD patients.

METHODS: Two hundred and seventy eight HIV infected patients were interviewed by the single investigator. Body fat composition, lipid profile, fasting insulin(FI) and oral glucose tolerance test were obtained from patients who reported fat maldistribution. Fasting plasma glucose and FI were used to determine insulin resistance(IR) by using the homeostasis model assessment Index. The history of ART and HIV infection were recorded.

RESULTS: The overall prevalence of LD was 17%. All of them had received ART including mono, double and HAART regimens. From patient's self evaluation, LD were reported mostly at face, buttock, legs, arms, and abdomen respectively. Twenty-eight percent, 54% and 15% of patients ranked their morphologic changes as mild, moderate and severe. Two-third of the patients had mixed syndromes and the rest had only fat wasting. Ninety-three percent of LD patients had at least 1 abnormality in either lipid or glucose metabolism. Eighty-eight percent had dyslipidemia, 21% had impaired glucose tolerance, 30% had IR and 27% had diabetes mellitus.

CONCLUSIONS: The prevalence of LD in this study slightly lower than in other studies. Clinical characteristics of LD in HIV infected Thai patients are similar to those previously reported. These patients have a high rate of lipid and glucose metabolism abnormalities which are major risk factors for cardiovascular events.

Keywords: AEGIS, Prevalence, Lipodystrophy, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Thailand, HIV Infections, HIV-Associated Lipodystrophy Syndrome, Antiretroviral Therapy, Highly Active, Risk Factors, Insulin Resistance, Body Composition, Hyperlipidemia, Insulin, Lipids, Fasting, Humans, epidemiology

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B10413