8th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV San Francisco, California - September 24 - 26, 2006

ASSOCIATION BETWEEN HEPATITIS C VIRUS COINFECTION AND REGIONAL ADIPOSE TISSUE VOLUME IN HIV-INFECTED MEN AND WOMEN

Antiviral Therapy 2006; 11:L19 (abstract no. 26)

PC Tien¹, P Bacchetti², B Gripshover³, E Turner Overton⁴, D Rimland⁵ and D Kotler^6
1University of California, San Francisco and Department of Veterans Affairs Medical Center, San Francisco, CA, USA; ²University of California, San Francisco, San Francisco, CA, USA; ³Case Western Reserve University, Cleveland, OH, USA; ⁴Washington University, St Louis, MI, USA; ⁵Emory University and Department of Veterans Affairs Medical Center, Atlanta, GA, USA; ⁶St. Luke’s Roosevelt Hospital, New York, NY, USA

BACKGROUND: Coinfection with hepatitis C virus (HCV) has been reported to be associated with a higher prevalence of clinical lipodystrophy, particularly lipoatrophy, than HIV infection alone. We examine the association between HCV and regional adipose tissue volume in HIV-infected men and women.

METHODS: Cross-sectional comparison of HIV/HCV-coinfected and HIV-monoinfected subjects from the study of Fat Redistribution and Metabolic Change in HIV infection (FRAM). A detectable HCV RNA defined HCV infection. Whole body MRI measured regional adipose tissue volume. Multivariate analysis determined the association of HCV infection and adipose tissue volumes in each of five anatomic sites: visceral, legs, lower trunk, upper trunk and arms. Separate models were run in men and women.

RESULTS: 26% of 329 women and 20% of 792 men were HIV/HCV-coinfected. HIV/HCV-coinfected and HIV-monoinfected women had similar amounts of subcutaneous adipose tissue (SAT) in the leg, lower trunk, upper trunk, arm, and in visceral adipose tissue (VAT). Similar findings were seen in men, except in leg SAT and VAT. HIV/HCV-coinfected men had more leg SAT (3.2 l versus 2.7 l, P=0.002) and less VAT (1.3 l versus 1.9 l, P=0.0001) when compared to HIV-monoinfected men. After multivariate adjustment, HCV infection remained associated with more leg SAT in men [12.2%, 95% confidence interval (CI): 0.3, 25.3, P=0.043]. HCV infection appeared to be less associated with VAT (-10%, 95% CI: -28, 11, P=0.31). Among HIV-monoinfected men, stavudine use was associated with less leg SAT (7% effect per year of use, 95% CI: -9, -5; P<0.001); a weaker association was seen between stavudine use and less leg SAT in HIV/HCV-coinfected men (-2% effect, 95% CI: -7, 3; P=0.45). The interaction of HIV/HCV coinfection with stavudine use had P=0.043. Indinavir was associated with less leg SAT (-4% in HIV-monoinfected, 95% CI: -6, -1; P=0.002 and -5% in HIV/HCV-coinfected, 95% CI: -11, 2; P=0.14).

CONCLUSION: Our findings suggest that HIV/HCV coinfection is not associated with less subcutaneous adipose tissue in men or women. HCV infection mitigates the loss of leg fat seen in HIV-infected men on stavudine.

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2006-09-24
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