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

PREVALENCE AND RISK FACTORS OF PUBIC LIPOMAS IN HIV-INFECTED PATIENTS

Antiviral Therapy 2006; 11:L24 (abstract no. 35)

G Guaraldi¹, G Orlando¹, N Squillace¹, A Roverato¹, D De Fazio², M Vandelli³, G Nardini¹, B Beghetto¹, M De Paola¹ and R Esposito^1
1Department of Medicine and Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy; ²Casa di cura Villa Salus, Reggio Emilia, Italy; ³Azienda Policlinico di Modena, Modena, Italy

The natural history of lipodystrophy (LD) and body fat changes is not known. The object of this study was to describe a new clinical picture apparently associated with LD characterized by the emergence of a subcutaneous lipoma in the pubic region. Prevalence and risk factors of pubic lipomas (PL) were analysed in a observational cross sectional study in patients with lipodystrophy attending a metabolic clinic. in northern Italy. Inclusion criteria were physician-confirmed diagnosis of LD according to the Multicenter AIDS Cohort Study (MACS) definition and a PL readily noticeable by patient or physician or to a casual observer. Laboratory studies, physical examinations, imaging findings and LD case definition were recorded. 582 patients, 214 females (36.7%) and 368 males (63.3%) were evaluated. The overall prevalence of PL in the study group was 9.4% (CI 7.2–12.1%, P<0.0001). PL were related to obesity and with the presence of subcutaneous fat pad in the dorsocervical region, commonly called ‘buffalo hump’ (BH). Prevalence of PL in non obese HIV-infected population was 8.0% (CI 5.9–10.6%, P<0.0001). Prevalence of PL in people with BH was 18.5% (CI 4.03–8.83%, P<0.0001) with a relative risk of 3.02 (CI 1.84–4.96%, P<0.0001). Logistic regression analysis identified the following possible risk factors for PL: BMI (β=0.18, es=0.04, P<0.001) gender (β=1.06, es=0.31, P<0.001) and HIV duration (β=-0.005, es=0.003, P=0.04). Both female sex and short HIV duration of therapy were considered to be proxy variables to BMI. A chain graph model was use to consider together risk factors for BH and PL. A non-null interaction between these two joint clinical picture was present which appear independent by the explicative variables, BMI and gender. PL prevalence is a clinical entity that needs to be included in the description of morphological alteration of LD. An unknown pathogenic mechanism common to BH and PL is hypothesized.

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2006-09-24
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