2nd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 13-15 September 2000, Toronto, Canada

CHANGES IN HIV-ASSOCIATED FAT MALDISTRIBUTION OVER TIME

Antiviral Therapy 2000; 5(Suppl. 5):9 (abstract no. O13)

KA Lichtenstein¹, KM Delaney², DJ Ward³, AC Moorman², FJ Palella⁴, SD Holmberg⁵ and K Wood⁵, the HOPS Investigators
¹Denver, CO.; ²CDC,Atlanta, GA.; ³Washington, D.C.; ⁴Chicago, IL.; and ⁵Apache Medical Systems, McLean, VA.,USA

BACKGROUND/OBJECTIVES:: In the last quarter of 1998, patients in the HIV Outpatient Study (HOPS) were surveyed and examined for the presence and severity of signs of fat maldistribution (fat atrophy/accumulation); a follow-up survey to determine changes over time is ongoing.

DESIGN: Evaluated signs of atrophy included sunken cheeks and fat loss on extremities, hips and buttocks. Accumulation was evaluated via facial fat over the parotid glands, dorsal cervical fat pad, and abdominal visceral fat accumulation. Patients with mild and those with no signs were categorized together to minimize misclassification of normal fat changes.

RESULTS: Of 1077 patients previously evaluated, 239 (22.2%) returned to their HOPS clinics during April-May 2000. Among these patients, presence of any moderate-to-severe fat maldistribution (27 with atrophy, 11 with accumulation, 14 with both) increased from 52/239 (21.8%) at initial survey to 91/239 (28.5%) at follow-up. At initial survey, 41 of 239 patients (17.2%) had signs of moderate/severe atrophy; of these, 7 (17.1%) improved to mild/none by follow-up. Of 198 patients with none/mild initially, 45 (22.7%) developed moderate/severe atrophy by follow-up; prevalence at follow-up was 33.1%. At initial survey, 25 of 239 patients (10.5%) had signs of moderate/severe accumulation; of these, 10 (40%) had improved to mild/none by follow-up. Of 214 patients with none/mild initially, 17 (7.9%) had developed moderate/severe accumulation by follow-up; follow-up prevalence was 13.4%.

CONCLUSIONS: Although the overall increase in fat misdistribution was modest, a comparison of atrophy versus accumulation revealed marked change over the 20 months, with greater incidence of atrophy (22%) versus accumulation (8%) and contrasting rates of improvement (atrophy, 17% versus accumulation, 40%). The prevalence of fat atrophy increased substantially (17 to 33% in under 20 months) in comparison with accumulation (10 to 13%).

000913
O13

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