8th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV


San Francisco, California - September 24 - 26, 2006

MAGNETIC RESONANCE IMAGING (MRI) PROVIDES A PRECISE AND FAST TOOL TO QUANTIFY BODY SHAPE CHANGES OF HIV-1 INFECTED PATIENTS WITHOUT RADIATION

Antiviral Therapy 2006; 11:L22 (abstract no. 31)

M Bickel1, J Eisen2, C Stephan1, T Lutz3, S Klauke4, V Jacobi2, S Zangos2 and S Staszewski1
1Department of Infectious Disease, University of Frankfurt, Frankfurt, Germany; 2Department of Radiology, University of Frankfurt, Frankfurt, Germany; 3Gemeinschaftspraxis Grueneburgweg, Frankfurt, Germany; 4Internistisches Facharztzentrum Stresemannallee, Frankfurt, Germany

BACKGROUND: Up to date there is no gold standard in measuring the variety of body shape changes associated with the HIV associated lipodystrophy with objective methods. Especially for the facial and dorsocervical region no standardized method has been established.

METHODS: Adult HIV-1 infected patients were consecutively recruited irrespective of treatment or symptoms. Fast T1-weighted FLASH Magnetic Resonance Imaging (MRI) sequences of the abdomen, the upper leg, at cheek and neck level were taken. Patients who not recognized changes in the specific areas of interest were compared to those who did not report changes.

RESULTS: One hundred patients were (87 m, 13 f) with a median age of 45.8 ±9.8 y, HIV-RNA-PCR of 40 copies/ml and 456 ±241 CD4 cells/µl were included. 85 were on HAART and 15 naïve. Patients reporting an increase of abdominal girth (n=61) had higher visceral (VAT) and total adipose tissue (TAT). Fat was less for patients reporting about sunken cheeks (n=42) as well as for fat loss of the legs (n=53) in the particular area. Patients reporting a buffalo hump had thicker fat areas in the dorsocervical region (n=22). All of these differences were highly statistical significant, details are listed in the Table.

CONCLUSIONS: The MRI provides a precise method with which several body regions, commonly affected by HIV associated lipodystrophy, can be objectively measured in a single, fast examination without the use of radiation.
Table 1. (Abstract 31)
Self reported body shape change Yes No P-value
Increase in abdominal size
  n 61 39 –
  TAT [cm2] 344 ±119 201 ±95 <0.0001
  VAT [cm2] 142 ±75 59 ±48 <0.0001
  VAT/TAT-ratio 0.42 ±0.2 0.29 ±0.2 0.0002
Increase in neck size
  n 22 78 –
  fat thickness at 7th cervical vertebra [cm] 4.0 ±1.8 2.3 ±1.4 0.0002
Sunken cheeks
  n 42 58 –
  facial fat at cheek level [cm2] 5.9 ±3.6 9.3 ±3.8 <0.0001
Fat loss of the legs
  n 53 47  
  mid thigh fat [cm2] 34.8 ±28.2 112.4 ±56.3 <0.0001
  percentage subcutaneous thigh fat [%] 8.8 ±6.6 23.5 ±9.9 <0.0001

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2006-09-24
31

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