AEGiS-07CROI: Factors related to the presence of fat redistribution in HIV-infected patients treated with protease inhibitor containing regimens, APROCO Cohort, 1999.

7th Conference on Retroviruses and Opportunistic Infections

San Francisco, CA - January 30 -February 4, 2000

FACTORS RELATED TO THE PRESENCE OF FAT REDISTRIBUTION IN HIV-INFECTED PATIENTS TREATED WITH PROTEASE INHIBITOR CONTAINING REGIMENS, APROCO COHORT, 1999.

Conf Retroviruses Opportunistic Infect 2000 Jan 30-Feb 2; 7:78 (abstract no. 14)

M. Saves, F. Raffi, J. Capeau, J. M. Lang, D. Peyramond, A. Basdevant, S. Roloff, G. Chene, W. Rozenbaum, And The Aproco Study Group
INSERM U. 330, Bordeaux; Nantes Hosp., Nantes; INSERM U. 402; Strasbourg Hosp., Strasbourg; Lyon Hosp., Lyon; Hotel-Dieu, Paris; X. Bichat Univ., Paris; Agence Natl. de Recherches sur le Sida (ANRS) and APPIT, France

OBJECTIVE: To study factors associated with lipodystrophy (LD) at M12 or M20 after starting a protease inhibitor (PI)-containing regimen in a large, representative sample of patients.

METHOD: The APROCO Cohort (ANRS EP11) enrolled 1283 patients at initiation of PI over 2 periods: 5/97-10/97 (period I) and 1/98-6/98 (period II). Presence of signs of fat redistribution was assessed at M20 in patients included during period I (53% indinavir, 22% ritonavir, 18% saquinavir) and at M12 in patients included during period II (31% indinavir, 55% nelfinavir). Predictive factors of the presence of at least one sign of LD: demographics, HIV/AIDS history, prior treatment with nucleoside analogs (NRTI), baseline body mass index (BMI), CD4+ count, CD8+ count, HIV RNA, PI and NRTI prescribed, CD4+ and HIV RNA responses to HAART at Month 1 and Month 4.

RESULTS: Among 207 patients with available data at M12, 60% had at least one sign: atrophy only in 16%, hypertrophy only in 23% and both in 20%. Hypertriglyceridemia (>2.2 mmol/l) was present in 26%, hypercholesterolemia (> 6.2 mmol/l) in 39% and diabetes in 3%. Among 202 patients with available data at M20, 60.4% had at least one sign: atrophy only in 14%, hypertrophy only in 23% and both in 23%. Hypertriglyceridemia (>2.2 mmol/l) was present in 30%, hypercholesterolemia (> 6.2 mmol/l) in 34% and diabetes in 9%. Only frequency of diabetes differed significantly between the groups seen at M12 and M20 (p=0.03). In the multivariate analysis, age > 55 years was associated with a higher prevalence of LD (OR=10.6 vs age < 35; p=0.04), and BMI < 19 was associated with a lower frequency of LD (OR=0.21 vs BMI 20-25; p=0.04). In the group assessed at M20, no factor was associated with a higher frequency of LD.

CONCLUSION: LD was evidenced in 60% of patients after one year of PI initiation. At M12, LD was associated with host factors. At M20, it was not possible to find predictive factors of LD. Immuno-virological characteristics at baseline and in response to HAART, type of PI used were not associated with a higher frequency of LD. Duration of exposure to the different antiretrovirals used will be further analyzed.

Keywords: AEGIS, HIV, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Ritonavir, Saquinavir, Indinavir, Protease Inhibitors, HIV Protease Inhibitors, Acquired Immunodeficiency Syndrome, HIV Infections, HIV-1, Nelfinavir, Reverse Transcriptase Inhibitors, Anti-HIV Agents, Lipodystrophy, Endocrine Diseases, Metabolism, Inborn Errors, Hypertriglyceridemia, Human, pathogenicity, AIDS

2000-01-30
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