Carmena J, Perez C, Tolosa N, Lanzan MT, Jordan M, Perez B, Santos C, Juan A, Monzon MS; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. WePeB4215.

J. Carmena, Hospital Dr Peset, Unidad De E. Infecciosas, C/ Gaspar Aguilar no90, 46017 Valencia, Spain, Tel.: +34 96 398 75 59, E-mail: jcarmena@provicom.com

Background: Lipodystrophy is currently the most important side effect of the HAART, producing aesthetics alterations, hyperlipidemia, isquemic cardiopathy, insuline resistance and diabetes mellitus. Objective: To determine the factors that cause of the lipodystrophy in a cohort of HIV patients. Design/Methods: A prospective cohorts study of HIV infected patients, comparing the different triple therapies, the estavudina (d4t) with the zidovudina (ZDV), age, sex. PCR assay with an inferior limit to 76 log10 copies/ml (Roche - The Hoffman) to determine viral load. A Kolmogorov -Smirnov test was used to see normality, thereafer according to the proceedings a comparative test of Student or by the test of U Mann-Whitney or by the test of Kruskal - Wallis was used, for qualitative variables Chi square, considering statically significant differences, p>0.05 bilateral. A not parametric survival analysis of Kaplan - Maier was performed, considering significant differences, the log - rank, Wilson and Tarone-Ware>0,05. We performed a logistics regression, being lipodystrophy the resultant variable, Wald forward, probability 0.05,0.1, with SPSS 7.5. Results: 232 patients treated with HAART, with a mean age of 35,5 years old, 117 of them were women, in the linebase (BL) with a viral load (VL) of 4,55+/-0,07log10 copies/ml, lymphocytes CD4 of 265+/-14 cels/ml. After a mean follow-up of 11,4+/-0,7 months a 67% presented undetectable viral load (UVL ), 35% of theses were treated with d4t and 37% with ZDV. There were not significant differences between all the previous parameters. They were distributed in two groups: group I, 208 patients without lipodystrophy; group II, 24 patients (10,3%) with lipodystrophy. Of all the patients treated with d4t+3TC+IDV:12 patients present with lipodystrophy and 46 patients do not present lipodystrophy, of all the patients treated with ZDV+3TC+IDV:1 patients present lipodystrophy and 45 patients do not present lipodystrophy, of all the patients treated with d4t+3TC+RTV:2 patients present lipodystrophy and 18 patients do not present lipodystrophy, of all the patients treated with ZDV+3TC+RTV: 24 patients do not present lipodystrophy, the patients treated with d4t+3TC+NFV:3 patients present lipodystrophy and 32 patients do not present lipodystrophy, of all the patients treated with ZDV+3TC+NFV:2 patients present lipodystrophy and 35 patients do not present lipodystrophy, 12 patients remaining were treated with triple with SQV. Of all the patients treated with triple therapie carrying d4t (119 patients), 20 patients presenting lipodystrophy and of all the patients treated with ZDV(113 patients), only 4 patients presented with lipodystrophy,RR = 3,14(IC95%:1,28-7,76), p = 0,0009. Comparing lipodystrophy of the patients with and without detectable viral load (12% vs 1,2%) we obtained, RR = 10(IC95%: 1,4-73), p = 0,02. Mean Survival with the undetectable load viral of patients without lipodystrophy was of 25+/-1 months (IC95%:23-27) and in those with lipodystrophy was of 39+/-1months (IC95%:36-42), log-rank 0,0003. In the logistics regression for the lipodystrophy - 2log likelihood = 112, goodness of fit = 144, patients treated with triple therapie with d4t presents an OR of 7,57,IC95%: 2,27-25,14, (B2,02; SE 0,61, SIG 0,0004), no entering the model: the undetectable load viral, the CD4 lymphocytes, the different IP or the sex. Conclusions: Lipodystrophy is produced in a 10% of the patients of our cohort, being estavudina and undetectable load viral main factors.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Anti-HIV Agents
• Antiretroviral Therapy, Highly Active
• Female
• HIV
• HIV Infections
• HIV Protease Inhibitors
• HIV Seropositivity
• Humans
• Lamivudine
• Lipodystrophy
• Longitudinal Studies
• Stavudine
• Viral Load
• Zidovudine

Other ID:

• GWAIDS0002933

UI: 102240427

From Meeting Abstracts