AEGiS-13IAC: Clinical factors related to the severity of fat redistribution in the HIV Outpatient Study (HOPS).

13th International AIDS Conference

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

Clinical factors related to the severity of fat redistribution in the HIV Outpatient Study (HOPS).

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrB704)

Lichtenstein K, Ward D, Delaney K, Moorman A, Young B, Palella F, Wood K, Holmberg S; K. Lichtenstein, Columbia Rose Medical Center, 4545 East 9th Ave, Denver, CO 80220, United States, Tel.: +1 303 393 8050, Fax: +1 303 320 1953, E-mail: didc.kal@juno.com

Objectives and

METHODS: To analyze factors related to physical manifestations of fat redistribution among patients in the HOPS, 1077 (89%) of patients visiting 8 clinics in 7 U.S. cities from 10/98-12/98 were interviewed and assessed by HOPS clinicians. We identified patients with fat redistribution using number and severity of affected body areas, then identified and analyzed associated factors using categorical analysis and logistic regression to evaluate associations with demographics, HIV/AIDS history, CD4+ cell (CD4) count and percent, and antiretroviral treatment history.

RESULTS: Of all respondents, 548 (51%) had no physical manifestations; 332 (31%) had mild to moderate findings, and 197 (18%) had moderate to severe findings suggestive of significant fat redistribution. In a logistic regression model adjusted for the effects of study site and all other variables in the model, the following factors were associated with significant fat redistribution: age (age > 40 vs. > = 40, p = .0001, 95% CI 'CI' '1.78-3.68'); duration of time since first positive HIV test and since AIDS diagnosis (HIV > = 7 years with AIDS > = 4 years vs. lesser duration, p = .0024, CI '1.24-2.78'); observed change in body mass index ('BMI' range of BMI change > = 2.0 vs. >2.0, p = .0023, CI '1.25-2.73'); use of D4T (ever vs. never used, p = .0001, CI '1.66-4.14'), and use of a protease inhibitor ('PI' use of an individual PI > = 2 years vs.> 2 years, p = .0013, CI '1.28-2.78').

CONCLUSION: HIV-associated fat redistribution is both frequent and apparently multifactorial in etiology. Likelihood of this syndrome increased and was strongly associated with increasing age and measures of increasing duration and severity of HIV disease. In addition to these independent factors, prevalence of fat redistribution appeared to be increased by the following drug factors: the use of D4T, and the use of a PI for 2 or more years.

Keywords: AEGIS, HIV Infections, HIV Seropositivity, Stavudine, Acquired Immunodeficiency Syndrome, Prevalence, Body Mass Index, Endocrine Diseases, United States, Human
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ThOrB704