9th Conference on Retroviruses and Opportunistic Infections Seattle, Washington - February 24 -February 28, 2002

Conf Retroviruses Opportunistic Infect 2002 Feb 24-28;9:abstract no. 31
A. Carr for the HIV Lipodystrophy Case Definition Study Group
St. Vincent’s Hosp. and Univ. of New South Wales, Sydney, Australia

BACKGROUND: There is no objective, validated, sensitive, specific, and readily applicable case definition of HIV lipodystrophy (LD).

METHODS: A European Medicines Evaluation Agency-initiated and industry-sponsored study was performed at 32 sites in the Americas (n=15), Europe (n=11), and Australasia (n=6) using a case-control methodology for identifying clinical, laboratory, and imaging features that independently discriminate LD cases. Recruitment was of consecutive HIV-infected adults free of active AIDS, with equal numbers of patients (and of cases and controls) recruited at each site. 1081 patients (15% female) were recruited: 417 cases (at least 1 moderate or severe LD feature identified by doctor and patient, except isolated abdominal obesity); 371 controls (no LD identified by doctor or patient, and no significant weight change since HIV diagnosis); and 288 non-assigned (neither case nor control). Cases and controls completed all assessments (demographics, antiretroviral and metabolic drug history, HIV disease, fasting metabolic bloods, and DEXA and abdominal CT). Models were generated from 504 randomly selected cases and controls by stepwise forward logistic regression of all parameters (excepting patient and physician LD assessments and antiretroviral history) significantly different between cases and controls on univariate analysis. Models were then validated in the remaining cases and controls.

RESULTS: A model including low trunk:peripheral fat ratio (DEXA), report of abdominal bloating, low leg fat % (DEXA), lower alcohol consumption, higher waist:hip ratio, higher total:HDL cholesterol ratio, higher anion gap, report of increased bleeding tendency, higher VAT:SAT ratio (CT), and greater age had sensitivity of 84.4% and specificity of 81.4%.

CONCLUSIONS: This model can diagnose HIV lipodystrophy objectively and relatively simply.

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Copyright © 2002 - Foundation for Retrovirology and Human Health. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed (AIDSLINE) from National Library of Medicine.