AEGiS-10CROI: Incidence of Lipoatrophy and Lipohypertrophy in the Women's Interagency HIV Study.

10th Conference on Retroviruses and Opportunistic Infections

Boston, MA USA - February 10 -14, 2003

Incidence of Lipoatrophy and Lipohypertrophy in the Women's Interagency HIV Study.

Conf Retroviruses Opportunistic Infect 2003 Feb 10-14;10th: abstract no. 736
Tien PC, Cole SR, Williams CM, Li R, Justman J, Cohen MH, Young M, Rubin N, Augenbraun M, Grunfeld C; Univ of California at San Francisco

BACKGROUND: Fat distribution changes including central fat gain and/or peripheral fat loss, often referred to as "lipodystrophy syndrome," have been linked with HIV infection and are the focus of increasing concern. We investigated the incidence of lipoatrophy (LA) and lipohypertrophy (LH) in HIV⁺ and HIV^- women from the Women's Interagency HIV Study (WIHS), a prospective multi-site study of the progression of HIV infection in women.

METHODS: We included 1,057 HIV⁺ and HIV^- women with prospective data collected semiannually on self-report of change (bi-directional) in body fat, anthropometric measurements, weight and bioelectric impedance analysis beginning in 1999 in the incidence analysis over an 18-month (mo) period (WIHS semiannual visits 11 to 14). LA and LH were defined by self-report of either a decrease or an increase in a body fat region over the previous 6 mos confirmed by change in the corresponding anthropometric measurement. Both LA and LH were studied peripherally (arms, legs, buttocks) and centrally (waist, chest, and upper back).

RESULTS: HIV⁺ and HIV^- women had similar distributions of age, race, and height. Over an 18-mo period, mean weight increased at a rate of 0.7 kg per visit in HIV^- women (robust 95% CI: 0.3, 1.1) and total body fat increased at a rate of 1.2 percent per visit (robust 95% CI: 0.4, 2.0) but both remained stable in HIV⁺ women. Among HIV⁺ women, the incidence of both peripheral LA (relative hazard [RH] = 2.4; 95% confidence interval [CI]: 1.6, 3.8) and central LA (RH = 2.1; 95% CI: 1.3, 3.3) were double that of HIV^- women. The incidence of peripheral LH was lower (RH = 0.6; 95% CI: 0.4, 0.8) among HIV⁺ compared to HIV^- women, while the incidence of central LH was similar in HIV⁺ and HIV^- women. The majority of the combined outcomes were either combined peripheral LA and central LA or combined peripheral LH and central LH.

CONCLUSIONS: These prospective data suggest that LA affecting both peripheral and central sites predominate in women with HIV. The simultaneous occurrence of peripheral LA and central LH was not common in these women.

Keywords: AEGIS, Lipodystrophy, Incidence, HIV Infections, HIV Seropositivity, HIV-Associated Lipodystrophy Syndrome, Adipose Tissue, Prospective Studies, Commonwealth of Independent States, Adult, Human, Female, epidemiology

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Copyright © 2003 - Foundation for Retrovirology and Human Health. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed (AIDSLINE) from National Library of Medicine.