7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 13–16 November 2005, Dublin, Ireland

EFFICACY AND SAFETY OF MEDICAL AND SURGICAL INTERVENTIONS FOR TREATING HIV-RELATED LIPODYSTROPHY IN WOMEN

G Orlando¹, G Guaraldi¹, S Cavuto¹, V Borghi¹, G Nardini¹, B Beghetto¹, C Cappi¹ and R Esposito^1
1 University of Modena and Reggio Emilia, Modena, Italy

Antiviral Therapy 2005; Supplement 3:L28 (abstract no. 43)

OBJECTIVES: HIV-related lipodystrophy syndrome (LD) in women is rarely described, and its progression is not well characterized.

METHODS: In a cohort of HIV+ Caucasian Italian women we evaluated whole-body DEXA scanning in comparison to HIV+ men with LD and HIV– pre-menopausal women. The efficacy and safety of dietary counselling, physical activity, antiretroviral switching, STI, surgical treatment and psychological support were combined to treat fat loss or accumulation, hyperlipaemia and insulin resistance and analysed in a 48-week FU longitudinal study.

RESULTS: HIV+ women with LD (n=137), HIV– women (n=70) and HIV+ men with LD (n=289) were analysed. Baseline evaluation of HIV+ women compared to HIV– women by age was 1.2 ±6.2 vs 48.0 ±6.3 (P<0.001) and BMI 22 ±3.3 vs 26.1 ±4.3 (P<0.001). DEXA, total fat mass (gr) was 12 212 ±5511 vs 23 231 ±7848 (P<0.001). Fat mass of the legs was 2762 ±1807 vs 8825 ±2866 (P<0.001) fat mass of the trunk was 6906 ±2914 vs 10 855 ±4423 (P=0.015). Main differences in LD diagnosis in females and males were as follows: lipoatrophy 21.8% vs 45.4% (P<0.0001), mixed forms 57.4% vs 34.7% (P<0.0001), dyslipidaemia 57.3% vs 73.6% (P=0.001); altered glucose tolerance 73.6% vs 75.0% (P=0.78). Treatment was assessed in 32 females and 75 males who completed FU. Analysis of variance of temporal evolution of LD variables showed the following changing pattern: vector 1: [BMI, WHR, thigh circumference] P=0.01; vector 2: [dermal and subcutaneous cheek thickness] P<0.0001; vector 3: [Glu, TG, LDL] P=0.07; vector 4: [VAS of aesthetic satisfaction of the face, Beck Inventory score, ABCD score question 7, ABCD score question 8] P<0.0001; vector 5: [fat and lean mass of the limbs and trunk] P=0.31.

CONCLUSIONS: Italian women with LD differ with previous reports of other ethnic groups. Interventions proposed in this multidisciplinary system are efficacious and safe to improve biochemical parameters, facial lipoatrophy and psycho-social aspects connected with LD.

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2005-11-13
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