Endocrine Abstracts

Introduction: Adipose tissue disturbances (lipodystrophy and obesity) are prevalent in patients infected with HIV. Our aims were to evaluate the prevalence of obesity and the association with lipodystrophy, the effect of gender, age, viral replication, duration of disease and cART in a population of HIV patients under cART.

Methods: In this retrospective study, 580 patients were included. The characteristics of the population are presented through percentage, mean and standard deviation. For comparison, t-test and chi-square test were used. Logistic regression model was used to adjust the confounding factors. Patients were classified according to the prevalence or absence of clinical lipodystrophy and in 4 categories of body composition: 1) without lipodystrophy (without lipoatrophy and without abdominal prominence-AP); 2) isolated AP; 3) isolated lipoatrophy; 4) mixed forms of lipodystrophy (with lipoatrophy and with AP). AP was defined according to the waist circumference criteria of the IDF.

Results: Of the 580 HIV patients (414 men), 5.17% were underweight, 40.69% normal weight, 34.66% overweight and 19.48% obese; 15.4% had no lipodystrophy; 30.62% isolated AP; 27.17% isolated lipoatrophy and 28.1% mixed form of lipodystrophy. In obese patients, clinical lipodystrophy was present in 28.6%, being significantly lower in patients with excess weight [odss ratio (OR)=0.12; 95% CI] and in those with obesity [OR=0.32; 95% CI], when compared with those of low weight, regardless of sex, age, duration of cART, HIV or viral load. There was an association (P<0.001) between BMI and body fat categories. The presence of lipoatrophy decreases with increasing BMI: in patients with low BMI, 24.1% had no lipodystrophy and 72.41% had lipoatrophy alone; in those who were overweight, most had mixed forms of lipodystrophy (41.24%), and AP was also common (39.69%); in those with obesity, most of them (70.3%) had isolated AP. The prevalence of obesity was not influenced by viral suppression, sex, age, duration of HIV infection or cART.

Conclusion: In this population of patients infected with HIV, excess weight, obesity or some degree of alteration in the distribution of body fat were very prevalent. The presence of clinical lipodystrophy was lower in overweight and obese patients than in those with low weight regardless of gender, age, duration of cART or infection with HIV and viral load. Patients with obesity had lower viral suppression, and the prevalence of obesity was not influenced by sex, age, duration of HIV infection or cART.