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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Metabolic function and the prevalence of lipodystrophy in a population of HIV-infected African subjects receiving highly active antiretroviral therapy
Journal of Acquired Immune Deficiency Syndromes, Volume 46, No. 4, Year 2007
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Description
OBJECTIVE: This study measured the prevalence of lipodystrophy and the metabolic effects of highly active antiretroviral therapy (HAART) in HIV-infected African subjects. METHODS: Prevalence was measured in 571 Rwandans receiving HAART for ≥6 months. Metabolic variables were measured in 100 HIV-positive adults with lipodystrophy, 50 HIV-positive nonlipodystrophic adults, and 50 HIV-negative controls. RESULTS: A HAART regimen of stavudine, lamivudine, and nevirapine was used by 81.6% of subjects; none received protease inhibitors. Lipodystrophy was observed in 34% (48.5% in urban groups and 17.3% in rural groups) of subjects, with a prevalence of 69.6% in those receiving HAART for >72 weeks. Peripheral lipoatrophy combined with abdominal lipohypertrophy was observed in 72% of lipodystrophic subjects. HIV-positive adults with lipodystrophy had a significantly higher waist-to-hip ratio (WHR; 0.99 ± 0.05 vs. 0.84 ± 0.03: P < 0.0005) than HIV-positive nonlipodystrophic adults. Total cholesterol concentrations (median [interquartile range], mmol/L) were significantly higher in the HIV-positive adults with lipodystrophy (3.60 [1.38]) than in HIV-positive nonlipodystrophic adults (3.19 [0.65]; P < 0.005) and control (3.13 [0.70]; P < 0.0005) groups. Impaired fasting glucose was observed in 18% of HIV-positive adults with lipodystrophy, 16% of HIV-positive nonlipodystrophic adults, and 2% of controls, but insulin levels did not differ. CONCLUSIONS: African subjects with lipodystrophy have increased WHR, glucose, and cholesterol levels. Glucose concentrations are also elevated in nonlipodystrophic HIV-positive subjects. Therefore, factors other than body fat redistribution contribute to the glucose intolerance. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Mutimura, Eugene
Rwanda, Butare
University of Rwanda
Stewart, Aimée Vivienne
South Africa, Johannesburg
University of the Witwatersrand
Rheeder, Paul
South Africa, Pretoria
University of Pretoria
Crowther, Nigel John
South Africa, Johannesburg
University of the Witwatersrand
Statistics
Citations: 128
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.1097/QAI.0b013e318158c0a6
ISSN:
15254135
Research Areas
Infectious Diseases
Noncommunicable Diseases
Study Design
Cross Sectional Study