AEGiS-15IAC: Study of long term metabolic and morphological side effects of antiretroviral therapy in HIV-1 infected Indian patients.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Study of long term metabolic and morphological side effects of antiretroviral therapy in HIV-1 infected Indian patients.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10163)

Patel KK, Patel AK, Patel JK, Shah VN, Mehta NN
ID clinic, Ahmedabad, India

BACKGROUND: Antiretroviral therapy (ART) is associated with unacceptable long-term metabolic side effects.

METHODS: Study design: Observational cross sectional study. HIV-1 infected patients completed more than 6 months on ART were looked for metabolic and morphological changes. All patients were followed clinically and by appropriate laboratory investigations. Various data regarding long-term side effects; facial lipoatrophy, limb thinning, buffalo hump, cricks belly; abnormalities in lipid profile were collected and analyzed.

RESULTS: 1510 patients had completed more than 6 months of ART. 207/1510 patients developed metabolic side effects related to ART. Characteristics of patients are as follows: 143 (69%) patients were male and 64 (31%) were female. Mean (±SD) age was 38.81 (±8.78) years for male and 40.32 (±9.03) years for female. Mean (±SD) weight of male and female patients was 65.23 (±10.07) kg and 56.96 (±9.92) kg respectively. Mean (±SD) duration for development of side effects from the start of therapy was 29.04 (±14.7) months. Side effects (Table 1) were observed at 8 months to 68 months. Many patients had multiple side effects. 82.61% patients were receiving d4T based, 11.59% were receiving AZT based therapy and 5.79% had received multiple NRTIS. [table: see text] Results showed that: Most of the patients were weighing >60kg. Lipid abnormalities were commonest side effect followed by facial & limb lipoatrophy. Severe hypertriglyceridemia (S.triglyceride >500mg%) was found in 16 patients. d4T was common drug associated with metabolic side effects. Lactic acidosis, a life threatening side effect was found in 8 patients.

CONCLUSION: In our study lipid abnormalities, facial lipoatrophy and limb thinning are commonest side effects. Stavudine based therapy (82.61%) was associated with metabolic side effects. Lactic acidosis, a life threatening side effects requires careful clinical evaluation & monitoring if suspected.

Keywords: AEGIS, HIV-1, Stavudine, Zidovudine, Antiretroviral Therapy, Highly Active, Acidosis, Lactic, Drug Therapy, Combination, Body Weight, Triglycerides, Cross-Sectional Studies, Female, Male, Humans, therapy, anatomy & histology, pathogenicity, adverse effects, drug therapy

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B10163