Prevalence and risk factors of lipodystrophy syndrome in acquired immunodeficiency syndrome patients treated with highly active antiretroviral therapy / 中华传染病杂志

ABSTRACT

Objective To investigate the prevalence and risk factors of highly active antiretroviral therapy (HAART)-associated lipodystrophy syndrome (LD) in patients with acquired immunodeficiency syndrome (AIDS) treated with HAART in China.Methods A total of 137 AIDS patients treated with HAART for more than 2 years were analyzed.Sixteen clinical parameters (including gender,age,baseline body mass index,baseline human immunodeficiency virus [HIV] viral load,stage of disease,routes of HIV transmission,baseline CD4+ T lymphocyte count,white blood cell count,fasting plasma glucose level,serum triglycerides level,serum cholesterol level and other laboratory results,and HAART regimens) that might be associated with HAART-LD occurrence were evaluated using Cox proportional hazards models.Results HAART regimens were significantly correlated with HAART-LD (P=0.031),while the remaining 15 factors were not associated with the risk of HAART-LD (all P＞0.05).Patients who received stavudine d4T)-containing regimen was 2.684 times more likely to develop HAART-LD than patients who received zidovudine (AZT)-containing regimen (95 ％ CI1.302-5.531,P=0.007) ; HAART-LD prevalence rates were gradually increased with treatment duration in both groups.First HAART-LD was seen at 24 weeks in both d4T group and AZT group,and the prevalence rates were 2.7％,1.6％ at 24 weeks,27.0％,7.9％ at 48 weeks and 37.8％,15.9％ at 96 weeks respectively.The prevalence of HAART-LD in d4T group was much higher than that in AZT group and the difference was statistically significant (x2 =8.285,P=0.004).Conclusions HAART regimen is an independent predictor of HAART-LD.HAART-LD tend to occur more frequently in patients treated with d4T or AZT,especially d4T.Our study recommends to avoid the use of d4T-contained HAART regimen.