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

EVOLUTION OF BODY COMPOSITION IN HIV-INFECTED LIPODYSTROPHIC MEN TREATED WITH ANTIRETROVIRAL THERAPY

Antiviral Therapy 2007; 12(Suppl. 2):L29 (abstract no. P-15)

E Degris¹, A Sommet¹, E Bonnet², P Massip², M Obadia², C Aquilina³, S Sire⁴, F Marion-Latard², B Perret², J Montastruc¹ and J Bernard^2
1Department of Pharmacology and Centre Midi-Pyrenees de Pharmacovigilance, de Pharmacoepidemiologie et d‘Informations sur le Medicament, Faculty of Medecine, University of Toulouse, Toulouse, France; ²Unit of Infectious and Tropical Disease, Purpan University Hospital, Toulouse, France; ³Unit of Dermatology, La Grave University Hospital, Toulouse, France; ⁴Unit of Interne Medicine, Cahors Hospital, Cahors, France

OBJECTIVE: The aim of this study was to analyse evolution of body composition in HIV-infected lipodystrophic men treated with antiretroviral drugs.

METHODS: We conducted a retrospective, longitudinal, observational study including HIV lipodystrophic men, (defined by a fat mass ratio (FMR) ≥1.6, which is the ratio of the percentage of trunk fat mass to the percentage of lower limbs fat mass), from Toulouse and Cahors hospitals (France). Records of body composition values (total, trunk, lower limb fat mass, total lean mass and Bone Mineral Density [BMD]) were determined by dual X-ray absorptiometry (DEXA) twice (that is DEXA 1 and DEXA 2 at least at one year intervals). For each DEXA, immuno-virological (CD4+ cell count¸ viral load) and epidemiological (age, body max index [BMI], duration of HIV infection) data were collected. Cumulative duration of exposure to each drug was estimated before the first DEXA and during the period of the study.

RESULTS: Eighty-four men were included: mean age 46, mean follow-up of 40 months, mean FMR1=2.08, mean FMR2=2.03. They were divided into three groups according to evolution of their lipodystrophy, based on the evolution of their lower limbs fat mass (LLFM) (±10%): group 1 =‘improvement’ (n=46; +39.3%), group 2 = ‘aggravation’ (n =20; -22.5%), and group three = ‘stable’ (n=18; +1.5%). At DEXA 1, the three groups were comparable for immuno-virological, epidemiological data, duration of follow-up, FMR and body composition. Drugs differed only on abacavir (P=0.02). Mean evolution of total body, trunk fat and total lean mass was, respectively, +25%/+20.2%/-0.8% in group one, -16.9%/-14.4%/-0.8% in group two and +5.2%/+5.7%/+0.4% in group three. Decrease in BMD was observed in the three groups: -0.003 g/cm² (group one)¸ -0.016 g/cm² (group two), -0.011 g/cm² (group three). Between the two DEXAs, a significant difference was observed in abacavir consumption (P=0.03).

CONCLUSION: These data show that lipodystrophy can improve slowly after several years, associated with a gain in total fat without modification in total lean mass. BMD seems to decrease irrespective of the evolution of lipodystrophy. We cannot conclude on a role of drugs in lipodystrophy.

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2007-07-24
P-15

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