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Titolo:
Lipodystrophic syndromes and hyperlipidemia in a cohort of HIV-1-infected patients receiving triple combination antiretroviral therapy with a protease inhibitor
Autore:
Rakotoambinina, B; Medioni, J; Rabian, C; Jubault, V; Jais, JP; Viard, JP;
Indirizzi:
Hop Necker Enfants Malad, Serv Immunol Clin, F-75743 Paris 15, France Hop Necker Enfants Malad Paris France 15 Clin, F-75743 Paris 15, France Hop Necker Enfants Malad, Dept Biostat, F-75743 Paris, France Hop Necker Enfants Malad Paris France F-75743 tat, F-75743 Paris, France
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 5, volume: 27, anno: 2001,
pagine: 443 - 449
SICI:
1525-4135(20010815)27:5<443:LSAHIA>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
REVERSE-TRANSCRIPTASE INHIBITORS; INSULIN-RESISTANCE; HIV-INFECTION; PERIPHERAL LIPODYSTROPHY; FAT; PATHOGENESIS; DYSLIPIDEMIA; INDINAVIR; MEN;
Keywords:
lipodystrophy; protease inhibitors; nucleoside analogs; hyperlipidemia; HIV infection;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Viard, JP Hop Necker Enfants Malad, Serv Immunol Clin, 149 Rue Sevres, F-75743 Paris15, France Hop Necker Enfants Malad 149 Rue Sevres Paris France 15 France
Citazione:
B. Rakotoambinina et al., "Lipodystrophic syndromes and hyperlipidemia in a cohort of HIV-1-infected patients receiving triple combination antiretroviral therapy with a protease inhibitor", J ACQ IMM D, 27(5), 2001, pp. 443-449

Abstract

Objectives: To assess the frequency and features of lipodystrophic syndromes in HIV-1-infected patients receiving highly active antiretroviral therapy (HAART) with a protease inhibitor (PI), and examine whether clinical and biologic abnormalities are always associated in these conditions. Methods: Retrospective-prospective single-center observational study of 175 patients. Comparisons for continuous variables by t-test and paired t-test, and Kaplan-Meier analysis of time to onset of lipodystrophy were performed. Results: In all, 51 patients (29%) had morphologic changes, after a mean HAART duration of 20.0 +/- 6.1 months, and were categorized into pure lipoatrophy (n = 16), mixed syndrome (truncal fat accumulation and face or limb lipoatrophy) (n = 30) or pure truncal fat accumulation (In = 5). Because of the small number, the latter group was not analyzed statistically. No differences were found among patients with lipoatrophy, mixed syndrome, or no lipodystrophy, in terms of gender, CD4 count, and HIV RNA plasma load at timeof HAART initiation, nor in response to treatment. Patients with a mixed syndrome were older. Patients with lipoatrophy had longer duration of HIV disease, pre-HAART exposure to nucleoside analog therapy, and HAART. Baselineand pre-HAART fasting triglyceride levels were higher in patients who developed lipoatrophy, whereas weight and fasting cholesterol were higher in patients who developed a mixed syndrome. After 12 and 24 months on HAART, triglycerides and cholesterol rose significantly in all patients, independently of lipodystrophy, whereas these parameters were not increased during nucleoside analog therapy. Conclusions: Nucleoside analog exposure appears as a risk factor for lipoatrophy. Age and nutritional status (reflected by baseline weight, triglycerides and cholesterol) may influence the evolution to lipoatrophy or a mixedsyndrome. Hyperlipidemia is observed in the absence of lipodystrophy and depends on PI exposure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/01/20 alle ore 01:04:43