AEGiS-13IAC: Risk of developing fat tissue alterations in antiretroviral therapy naive women.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Risk of developing fat tissue alterations in antiretroviral therapy naive women.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrB702)

Galli M, Ridolfo AL, Gervasoni C, Adorni F, Ravasio L, Gianelli E, Corsico L, Pizzuto M, Piazza E, d'Arminio Monforte A, Moroni M
M. Galli, 'L.Sacco'Hospital, Via G.B. Grassi, 74, 20157 Milano, Italy, Italy, Tel.: +39(0)23560010, Fax: +39(0)23560805, E-mail: masgalli@mailserver.unimi.it

BACKGROUND: Fat tissue alterations (FTAs) are frequent in women treated with antiretroviral (ARV) drugs and present pleomorphic clinical aspects. Aim of the study was to assess the role of protease inhibitors (PIs) and NRTIs in inducing FTAs in ARV-experienced and naive women. Patients and

METHODS: A cohort of outpatients receiving the same ARV treatment for at least 3 months were consecutively enrolled. FTAs were clinically diagnosed according a schedule adopted in September '97 and classified as prevalent fat loss (FL), fat accumulation (FA) and fat redistribution (FR), defined as breast enlargement accompanied by lower limb subcutaneous fat wasting.

RESULTS: The cohort included 131 naive and 190 ARV-experienced women. FTAs were observed in 122/321 (38%) women in a median follow-up of 822 days. In multivariate analysis, PIs OR 3.3, 95%CI 2.1-5.2, p = .0000) and d4T treatment (OR 2.0, 95% CI 1.2-3.3, p = 0.0058) were associated with an increased risk of FTAs. PIs (OR 6.3, 95%CI 2.5-15.9, p = 0.0001) but not d4T, were associated with an increased risk in naive patients. Cumulative time-dependent probability of developing FTAs was increased in patients treated with PIs and in ARV-experienced women (p = 0.0000). FR (72 cases observed), was associated to younger age (p = 0.0445) and in naive woman to PI treatment (p = 0.0442). FR showed also a shorter time to presentation than FL and FA, particularly in patients receiving PI and in ARV-experienced women. FL was associated to d4T treatment, with a borderline significance in a multivariate analysis (OR 2.5, 95% CI 0.9-7.2, p = 0.0808). This association resulted more evident considering only naive women (OR 4.2, 95%CI 0.9-18.3, p = 0.0579).

CONCLUSION: Our data support the existence of different mechanisms involved in causing FTAs. The relatively rapid presentation of FR in naive women suggests a potential role of the immune modification induced by the ARV therapy.

Keywords: AEGIS, Stavudine, Adipose Tissue, Human, Female
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