Prevalence of HIV-associated lipodystrophy in Brazilian outpatients: relation with metabolic syndrome and cardiovascular risk factors

• Published in: Arquivos brasileiros de endocrinologia e metabologia Vol. 52; no. 4; pp. 658 - 667
• Main Authors: Diehl, Leandro A, Dias, Janaína R, Paes, Aline C S, Thomazini, Maria C, Garcia, Lorena R, Cinagawa, Eduardo, Wiechmann, Susana L, Carrilho, Alexandre J F
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01.06.2008
• Subjects: Adult; Anti-HIV Agents - therapeutic use; Body Mass Index; Brazil - epidemiology; Female; HIV-Associated Lipodystrophy Syndrome - diagnosis; HIV-Associated Lipodystrophy Syndrome - epidemiology; Humans; Male; Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Outpatients; Prevalence; Risk Factors; Sex Factors
• ISSN: 1677-9487
• DOI: 10.1590/S0004-27302008000400012

Lipodystrophy in HIV-infected patients (LDHIV) affects 40-50% of HIV-infected patients, but there are no data on its prevalence in Brazil. The aim of this study was to assess the LDHIV prevalence among HIV-infected adult Brazilian individuals, as well as to evaluate LDHIV association with cardiovascular risk factors and the metabolic syndrome (MS). It was included 180 adult HIV-infected outpatients consecutively seen in the Infectology Clinic of Universidade Estadual de Londrina. Anthropometric and clinical data (blood pressure, family and personal comorbidities, duration of HIV infection/AIDS, antiretroviral drugs used, CD4+ cells, viral load, fasting glycemia and plasma lipids) were obtained both from a clinical interview as well as from medical charts. LDHIV was defined as the presence of body changes self-reported by the patients and confirmed by clinical exam. MS was defined using the NCEP-ATPIII criteria, reviewed and modified by AHA/NHLBI. A 55% prevalence of LDHIV was found. Individuals with LDHIV presented a longer infected period since HIV infection, longer AIDS duration and longer use of antiretroviral drugs. In multivariate analysis, women (p=0.006) and AIDS duration >8 years (p<0.001) were independently associated with LDHIV. Concerning MS diagnostic criteria, high blood pressure was found in 32%, low HDL-cholesterol in 68%, hypertriglyceridemia in 55%, altered waist circumference in 17% and altered glycemia and/or diabetes in 23% of individuals. Abnormal waist and hypertriglyceridemia were more common in LDHIV-affected individuals. MS was diagnosed in 36%. In multivariate analysis, the factors associated with MS were: BMI >25 kg/m(2) (p<0.001), family history of obesity (p=0.01), indinavir (p=0.001) and age >40 years on HIV first detection (p=0.002). There was a trend to higher frequency of LDHIV among patients with MS (65% versus 50%, p=0.051). LDHIV prevalence among our patients (55%) was similar to previous reports from other countries. MS prevalence in these HIV-infected individuals seems to be similar to the prevalence reported on Brazilian non-HIV-infected adults.