9th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 19-21 July 2007, Sydney, Australia

GENDER INDEPENDENT TH1/2 CYTOKINE DYSBALANCE ASSOCIATED WITH LIPODYSTROPHY IN HIV-PATIENTS

Antiviral Therapy 2007; 12(Suppl. 2):L27 (abstract no. P-10)

L Pontes-Cardoso¹, LR Souza¹, M Peraçoli¹, M Stankov², PC Pereira¹ and GMN Behrens^2
1Sao Paulo State University, Botucatu, Brazil; ²Hannover Medical School, Hannover, Germany

OBJECTIVES: Abnormal fat redistribution and metabolic abnormalities, termed lipodystrophy syndrome, are frequently observed side effects of antiretroviral therapy. We analysed the relation between Th1/2 cytokines with lipodystrophy and various metabolic parameters including serum lipids, adiponectin, leptin, and insulin resistance in female and male HIV-patients on highly active antiretroviral therapy.

METHODS: Cross-sectional study in 84 HIV-patients with and without lipodystrophy enrolled in a Brazilian ambulatory HIV clinic.

RESULTS: Patients with lipodystrophy had a higher insulin resistance index (HOMA-IR 3.57 ±2.4 versus 2.36 ±1.6, P<0.05), lower adiponectin (4.3 ±3.6 versus 6.2 ±3.8 pg/µl, P<0.05) but comparable leptin levels. Lipodystrophic patients had significantly higher levels of TNF-α (635.5 ±131.9 versus 351.8 ±146.9 pg/µl, P<0.001) and IL-10 (49.2 ±12.6 versus 39.2 ±16.5, P<0.01), but lower circulating Th1-cytokines including TNF-γ (361.1 ±149.6 versus 568.5 ±174.3, P<0.001) and IL-2 (101.8 ±23.5 versus 113.3 ±23.0, P<0.02). The combination of ‘high’ circulating TNF-α receptor 2 and ‘low’ TNF-γ was highly predictive for the presence of lipodystrophy in both males and females. Differences of metabolic parameters associated with lipodystrophy were heavily influenced by gender. Differences in cytokine levels of TNF-α, TNF-γ, and IL-2 associated with lipodystrophy remained significant in both males and females.

CONCLUSION: Lipodystrophy is associated with a significant dysbalance of Th1/2 cytokines towards low circulating TNF-γ and IL-2 levels but higher proinflammatory TNF-α concentrations. These data implicate a relevant impact of the immune system in the pathogenesis of the HIV-therapyassociated lipodystrophy syndrome.

Download PDF of this abstract.

2007-07-24
P-10

Copyright © 2007 - International Medical Press Ltd. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Medical Editor, International Medical Press, 36 St Mary-at-Hill, London EC3R 8DU, United Kingdom.