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Pronounced lipoatrophy in HIV-infected men receiving HAART for more than 6 years compared with the background population

  1. AB Hansen1,3,
  2. B Lindegaard1,2,
  3. N Obel3,
  4. O Andersen4,
  5. H Nielsen5,
  6. J Gerstoft1

Article first published online: 24 NOV 2005

DOI: 10.1111/j.1468-1293.2005.00334.x

Issue

HIV Medicine

HIV Medicine

Volume 7, Issue 1, pages 38–45, January 2006

Additional Information

How to Cite

Hansen, A., Lindegaard, B., Obel, N., Andersen, O., Nielsen, H. and Gerstoft, J. (2006), Pronounced lipoatrophy in HIV-infected men receiving HAART for more than 6 years compared with the background population. HIV Medicine, 7: 38–45. doi: 10.1111/j.1468-1293.2005.00334.x

Author Information

  1. 1

    Department of Infectious Diseases

  2. 2

    Copenhagen Muscle Research Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen,

  3. 3

    Department of Infectious Diseases, Odense University Hospital, Odense,

  4. 4

    Department of Infectious Diseases, Hvidovre University Hospital, Copenhagen

  5. 5

    Department of Infectious Diseases, Aalborg Hospital, Aalborg, Denmark

* Ann-Brit Eg Hansen, Department of Infectious Diseases M5132, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark. Tel:+45 35 45 77 26; fax:+45 35 45 66 48; e-mail: ann-brit.e.g.hansen@rh.hosp.dk

Publication History

  1. Issue published online: 24 NOV 2005
  2. Article first published online: 24 NOV 2005
  3. Received: 27 October 2004; accepted 8 April 2005

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Keywords:

  • dual-energy X-ray absorptiometry;
  • fat distribution;
  • lipids;
  • lipoatrophy

Objectives

To establish the prevalence and quantify the severity of body fat redistribution and dyslipidaemia in HIV-infected men after long-term highly active antiretroviral therapy (HAART) compared with the background population.

Methods

In a cross-sectional study, we included 87 HIV-infected men who had received HAART for at least 6 years and 34 HIV-negative men. Regional body composition was assessed using dual-energy X-ray absorptiometry. Fasting metabolic parameters were obtained. Associations between regional body fat distribution and metabolic parameters were evaluated.

Results

HIV-infected patients and controls did not differ with regard to height and lean body mass. Compared with controls, HIV-infected men had reduced total fat mass (median 12.3 versus 19.2 kg, P<0.001), limb fat mass (4.3 versus 7.9 kg, P<0.001), and trunk fat mass (6.7 versus 10.8 kg, P<0.001) and higher trunk/limb fat ratio (1.7 versus 1.2, P<0.001). Also, patients without clinical lipodystrophy had reduced amounts of limb and trunk fat. In HIV-infected men, triglyceride levels were higher (2.0 versus 1.2 mmol/L, P<0.001), high-density lipoprotein (HDL)-cholesterol levels were lower (1.2 versus 1.3 mmol/L, P<0.05) and insulin levels were higher (40.8 versus 29.9 pmol/L, P<0.01) than in controls. All adverse metabolic parameters correlated with increased trunk/limb fat ratio, and insulin levels correlated positively with trunk fat mass (P<0.01).

Conclusion

Peripheral as well as central fat loss is a general characteristic of HIV-infected men after long-term HAART. Although lipoatrophy was the dominant morphological presentation, the adverse metabolic parameters were mainly associated with the increased ratio of trunk/limb fat.

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