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LIPODYSTROPHY RISK FROM HIV-1 THERAPY (p 592)
February 21, 2001The risk of lipodystrophy (abnormal fat distribution) in HIV-1 individuals undergoing antiretroviral therapy cannot be attributed to one antiretroviral agent, conclude authors of a study in this week's issue of THE LANCET.
Lipodystrophy among HIV-1-infected patients receiving antiretroviral therapy was formally described as a clinical entity in 1998. However, the risk factors for lipodystrophy in patients infected with HIV-1 who are treated with highly active antiretroviral therapy (HAART) containing HIV-1 protease inhibitors are poorly understood. Esteban Martinez and colleagues from the University of Barcelona, Spain, aimed to identify the risk factors for lipodystrophy in HIV-1-infected adults on HAART.
After an average follow-up of 18 months, 85 (17%) of the 494 patients developed some type of lipodystrophy. The incidences of any lipodystrophy, lipodystrophy with subcutaneous lipoatrophy, and lipodystrophy with central obesity were 11.7, 9.2, and 7.7 per 100 patient-years. Women were at an increased risk of any lipodystrophy than men; both heterosexuals and homosexuals were at higher risk than intravenous drug users; lipodystrophy risk was increased with age, and duration of exposure to antiretroviral therapy.
Esteban Martinez comments: "Clinical research on lipodystrophy has usually rested on the idea that it was merely a complex adverse event related to individual antiretroviral agents or families of drugs. Our study suggests that the risk of lipodystrophy is mainly related to the total exposure to HAART and only to a lesser degree to specific antiretroviral drugs. In addition, we have identified risk factors not related to antiretroviral therapy, such as age and sex, that have not received adequate attention until now. Future research should focus on these new risk factors". (Quote by e-mail; does not appear in published paper).
Contact: Dr Esteban Martinez or Dr Jose M Gatell, Infectious Diseases Unit, Hospital Clinic, C/ Villarroel 170, 08036 Barcelona, Spain; T) +34 93 22 75430; M) +34 609 889132;; F) +34 93 45 14438; E) esteban@intercom.es or gatell@medicina.ub.es
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