Miller K, Jones E, Yanovski J, Shankar R, Feuerstein I, Falloon J; Conference on Retroviruses and Opportunistic Infections.

Program Abstr 5th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 5th 1998 Chic Ill. 1998 Feb 1-5; 5th: 157 (abstract no. 413).

National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.

Patients on long-term therapy with indinavir (Crixivan ((R))) have reported increased abdominal girth in the absence of weight gain, and some have symptoms of abdominal distention and fullness. Patients with such symptoms have attached the moniker "Crixbelly" to this condition. Abdominal CT scans in several of our earliest patients with such complaints suggested disproportionate accumulation of intra-abdominal fat. We then formally evaluated total adipose tissue (TAT) and visceral adipose tissue (VAT) by abdominal CT scan using standard methods for measurement of fat in a single CT cut at the L4/L5 level in 37 HIV-infected men who had CT scans for clinical indications. Thirteen of these patients were not receiving indinavir; 14 had been receiving indinavir for more than 6 months but had no abdominal symptoms, and 10 had been receiving indinavir for more than 6 months and had abdominal complaints. The mean ratio of visceral fat to total abdominal fat (VAT:TAT) for these 3 groups was 0.44, 0.60, and 0.73 respectively (ANOVA p = 0.008). However, the mean body mass index (BMI) for the three groups (24.3 kg/m(2), 25.8 kg/m(2), and 25.0 kg/m(2)) was similar (p = 0.35) indicating that intra-abdominal fat deposition is not a function of increased overall body weight in the indinavir groups. The VAT:TAT ratio in these patients correlates with both serum cholesterol (r = .36) and serum triglyceride (r=.43) levels suggesting an associated underlying abnormality of lipid metabolism. We conclude that HIV-infected patients on long-term indinavir therapy experience an accumulation of visceral fat that may cause abdominal complaints. It is not known whether similar abnormalities in fat distribution are associated with other HIV protease inhibitors. Further investigation of this phenomenon is on-going.

Publication Types:

• Meeting Abstracts

Keywords:

• Abdomen
• Acquired Immunodeficiency Syndrome
• Adipose Tissue
• Body Mass Index
• HIV Infections
• HIV Protease Inhibitors
• Humans
• Indinavir
• Male
• Obesity
• Tomography, X-Ray Computed
• Weight Gain
• radiography

Other ID:

• 98929344

UI: 102235997

From Meeting Abstracts