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. 2022 Mar;61(1):11-18.
doi: 10.20471/acc.2022.61.01.02.

REVERSIBILITY OF LIPOATROPHY IN HIV-INFECTED PATIENTS TAKING ANTIRETROVIRAL THERAPY: A COHORT STUDY WITH ULTRASOUND ASSESSMENT

Ana Šoštarić Zadro  1 , Klaudija Višković  1 , Josip Begovac  1
Affiliations

REVERSIBILITY OF LIPOATROPHY IN HIV-INFECTED PATIENTS TAKING ANTIRETROVIRAL THERAPY: A COHORT STUDY WITH ULTRASOUND ASSESSMENT

Ana Šoštarić Zadro et al. Acta Clin Croat. 2022 Mar.

Abstract

The aim of this study was to characterize and compare changes in subcutaneous fat in the malar, brachial and crural region in a cohort of HIV-infected patients taking antiretroviral therapy. This prospective longitudinal study included 77 patients who were selected from the initial cohort evaluated in 2007 and 2008. We examined reversibility of lipoatrophy measured by ultrasound over at least five-year period and factors related to its reversibility. All 46 patients who used stavudine switched from stavudine to another combination. Of 58 patients on zidovudine, 16 (28%) were on a zidovudine based regimen at the second follow up. There was evidence for subcutaneous fat increase in the malar area (p<0.001) and no increase in the brachial and crural areas. Patients who were smokers and had poor adherence to the Mediterranean diet had a thinner malar area at the follow up measurement (p=0.030) and smaller increase in subcutaneous malar fat compared to others (p=0.040). Our study suggested that modest increase of subcutaneous fat in malar area coincided with stopping stavudine and fewer usage of zidovudine. Lifestyle with non-adherence to the Mediterranean diet and smoking were associated with a smaller increase in subcutaneous malar fat.

Keywords: Antiretroviral therapy; Lipoatrophy; Mediterranean diet; Ultrasound.

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Figures

Fig. 1
Fig. 1
Subcutaneous fat tissue thickness in malar (A), brachial (B) and crural (C) region at the first and follow up visit measured by ultrasound. Horizontal line represents the median. There was a statistically significant difference between the two visits in the malar (p<0.001) but not in the brachial (p=0.498) and crural (p=0.068) region. Q1 = first quartile; Q3 = third quartile; Wilcoxon signed-rank test
See this image and copyright information in PMC

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