Lipohypertrophy and nutritional profile among people living with HIV in Southern Brazil

ABSTRACT: Introduction: People living with the human immunodeficiency virus (HIV) are generally overweight or have an altered body composition as compared to healthy individuals, showing a change in nutritional profile over time. Objective: The aim of the study was to characterize the nutritional status, estimate the prevalence of lipodystrophy, and examine the association between lipohypertrophy and lipid profile alterations, and other clinical data of HIV-infected individuals. Methods: This was a cross-sectional study on male and female subjects living with HIV, treated at a specialized outpatient clinic, aged 18 years old and over, whether using the antiretroviral therapy or not. Results: The sample consisted of 420 people with a mean age of 43.8 years (standard deviation 11.7). The length of time of the HIV infection averaged 74.6 months, and 91% of the respondents were on antiretroviral therapy. Lipodystrophy prevalence was 35.7%. Of these, 82 (54.7%) presented lipohypertrophy, 61 (40.7%) had lipoatrophy and 7 (4.6%) had a mixed syndrome. Female gender, body mass index, fat percentage, waist circumference and waist-hip ratio were positively associated with the presence of lipohypertrophy (p<0.001). High mean total cholesterol (p=0.015) and LDL fraction (p=0.028) also showed a statistically significant association with lipohypertrophy. The sampled participants had a nutritional profile compatible with overweight or obesity. No association was found between lipohypertrophy and ART and the therapy duration. Conclusion: Considering the consequences of overweight as a cause of various pathological conditions, preventive measures and interventions are highly recommended for this population

Prevalência de lipodistrofia em pessoas vivendo com HIV atendidos em Tubarão, Santa Catarina

Introduction: HIV-associated lipodystrophy syndrome is a major adverse effect of highly active antiretroviral therapy (HAART), although it also occurs among people living with HIV who do not receive any pharmacological treatment. Lipodystrophy diminishes patients’ quality of life and may hinder treatment compliance or lead to its abandonment. Objective: To estimate the prevalence of lipodystrophy and associated factors in individuals living with HIV. Methods: Cross-sectional study conducted from October 2015 to March 2016. A sample was recruited from individuals living with HIV who attended an outpatient clinic in Tubarão, state of Santa Catarina, Brazil. We collected information on demographics, lifestyle, HIV infection, and clinical aspects. Lipodystrophy was diagnosed through patient self-report associated with anthropometry. Results: We surveyed 405 patients (most were white men; mean age 43.7 years). The mean duration of HIV infection was 74.6 months, and 90.1% of the respondents were taking antiretroviral therapy. The prevalence of lipodystrophy was 34.2%, of whom 43% had lipoatrophy, 52% had lipohypertrophy, and 5% had a mixed form. There was a statistical association between the presence lipodystrophy and female gender [OR = 1.77 (95% CI 1.35 to 2.32)] and the duration of HIV infection ([OR = 1.00 (95% CI 1.00 to 1.04)]. Conclusion: Lipodystrophy was prevalent in more than one-third of the surveyed subjects, which is a warning signal. Lipodystrophy affects quality of life and adherence to treatment, and may cause cardiovascular damage in this population.Introdução: A síndrome lipodistrófica do HIV causada pelo uso dos antirretrovirais é considerada importante efeito adverso decorrente do uso de antirretrovirais, porém também é evidenciada entre pessoas que vivem com HIV sem uso de tratamento farmacológico. A lipodistrofia diminui a qualidade de vida dos pacientes e inclusive compromete a adesão ou causa abandono do tratamento. Objetivo: Estimar a prevalência de lipodistrofia e fatores associados em indivíduos que vivem com HIV. Métodos: Estudo transversal realizado entre outubro de 2015 e março de 2016. A casuística foi recrutada entre indivíduos que vivem com HIV em acompanhamento ambulatorial em Tubarão (SC). Foram coletados dados sócio-demográficos, hábitos de vida, aspectos clínicos e da infecção pelo HIV. O diagnóstico de lipodistrofia foi feito pelo autorrelato do paciente associado a antropometria. Resultados: Foram estudados 405 pacientes com média de idade de 43,7 anos, sendo a maioria homens e de cor branca. O tempo de infecção pelo HIV teve média de 74,6 meses e 90,1% dos entrevistados faziam uso de terapia antirretroviral. A prevalência de lipodistrofia foi de 34,2%, sendo que 43% apresentavam lipoatrofia, 52% lipo-hipertrofia e 5% a forma mista.Houve associação estatística entre o sexo feminino[RP = 1,77 (IC95%1,35-2,32)] e o tempo de infecção pelo HIV ([RP=1,00 (IC95% 1,00-1,04)]com a presença lipodistrofia. Conclusão: A prevalência de lipodistrofia encontrada em mais de um terço da amostra estudada serve de alerta, vista que além de afetar a qualidade de vida e adesão ao tratamento, pode ocasionar outros riscos, como doenças cardiovasculares nesta população