medigraphic.com
SPANISH

Revista Cubana de Farmacia

ISSN 1561-2988 (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2012, Number 2

<< Back Next >>

Rev Cubana Farm 2012; 46 (2)

Lipodystrophy syndrome in HIV/AIDS patients receiving highly active antiretroviral therapy in Tepic, Mexico

Fernández ARA, Gutiérrez RCC, Castro MP, Flores GA, Cancino MME
Full text How to cite this article

Language: Spanish
References: 23
Page: 202-212
PDF size: 72.41 Kb.


Key words:

severe lipodystrophy syndrome, HIV/AIDS, highly active anti-retroviral therapy.

ABSTRACT

Objective: to establish the relationship between lipodystrophy syndrome and highly active anti-retroviral therapy in HIV/AIDS patients.
Methods: a cross-sectional, descriptive and co-relational study was conducted in HIV/AIDS patients, who had received highly active antiretroviral therapy in Centro Ambulatorio de Prevención y Atención del Sida e Infecciones de Transmisión Sexual (CAPASITS) de Tepic in Nayarit, Méjico from March to December, 2007. The definition and diagnosis of this syndrome was based on the method developed by the National Center in HIV Epidemiology and Clinical Research (NCHECR) method in Australia. The Chi square test evaluated the dependence between syndrome and therapy. One hundred seventy five patients (128 men and 47 women) aged 19-72 years were evaluated.
Results: one hundred forty one patients (80.6 %) were diagnosed with lipodystrophy syndrome (CI95%74,7-86,4 %); 82.6 % corresponded to men and 74.5 % to women. According to severity, 17 % classified as grade 1; 1.3 % in grade 2; 10 % in grade 3 and 51 % as grade IV. The Chi square tests for the evaluation of dependence between syndrome and therapy were not significant.
Conclusions: severe lipodystrophy syndrome is a serious health problem for HIV/AIDS patients receiving antiretroviral therapy or not. It adds a significant cardiovascular risk that must be considered for prevention or treatment. Although the results may be biased or restricted, they represent an important approach to planning and performing health interventions that will reduce the impact of the syndrome on the health of HIV/AIDS patients.


REFERENCES

  1. Hoffman C, Mulcahy F. Perspectives. En: Hoffman C, Rockstroh J, Kamps BS (editores). HIV Medicine 2006. Cologne: Flying Publisher; 2006. p. 89-93.

  2. Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, and Cooper DA. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998;2:F51-8.

  3. Haugaard SB, Andersen O, Hales C N, Halsall I, Rosenfalck AM, Iversen J, Madsbad S. Hyperproinsulinaemia in normoglycaemic lipodystrophic HIV-infected patients. Eur J Clin Invest. 2006,36:436-45.

  4. Gutiérrez M, Mateo G, Vidal F, Domingo P. Toxicogenética del tratamiento antirretroviral (I): lipodistrofia, alteraciones metabólicas y arteriosclerosis. Enferm Infecc Microbiol Clin. 2008;26(Supl 6):18-23.

  5. Carr A, Samaras K, Thorisdottir A, Kaufmann GR, Chisholm DJ, Cooper DA. Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor- associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet. 1999;353:2093-9.

  6. Abby Shevitz, Wanke CA, Falutz J, Kotler, DP. Clinical perspectives on HIVassociated lipodystrophy syndrome: an update. AIDS. 2001;15:1917-30.

  7. Behrens G, Schmidt RE. Síndrome de Lipodistrofia. En: HIV Medicine 2005, versión en español Gustavo Reyes-Terán editor. México DF: CIENI-INER; 2005.

  8. Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, et al. A syndrome of peripheral lipodystrophy, hyperlipidemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998;12:F51-8.

  9. Carr A, Samaras K, Thorisdottir A, Kaufmann GR, Chisholm DJ, and Cooper DA. Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor- associated lipodystrophy, hyperlipidemia, and diabetes mellitus: a cohort study. Lancet. 1999;353:2093-9.

  10. Dong KL, Bausserman LL, Flynn MM. Changes in body habitus and serum lipid abnormalities in HIV-positive women on highly active antiretroviral therapy (HAART). J Acquir Immune Dc Syndr. 1999;21:107-13.

  11. Reboli AC, Marshall S. Changes in body habitus in HIV-infected patients treated with protease inhibitors. 36th Annual Meeting of the Infectious Diseases Society of America. Denver, 1998 [abstract 476 Sa]. Available from: http://journals.lww.com/aidsonline/fulltext/1999/12240/fat_distribution_and_metabolic_changes_in_patients.2.aspx#P16

  12. Rosenberg H, Mulder J, Sepkowitz K, Giordano M. `Protease paunch' in HIV. persons receiving protease inhibitor therapy: Incidence, risks and endocrinologic evaluation. Fifth Conference on Retroviruses and Opportunistic Infections. Chicago, February 1998 [abstract 408]. Available from: http://www.lancet.com/journals/lancet/article/PIIS0140-6736%2805%2977774-6/fulltext

  13. Viraben R, Aquilina C. Indinavir-associated lipodystrophy. AIDS. 1998;12:F37-9.

  14. Wong K, Ho T, Chan C, Lee S. Indinavir-associated facial atrophy in HIVpositive 13 patients. 12th International Conference on AIDS. Geneva, June 1998 [abstract 12299]. Available from: http://journals.lww.com/aidsonline/fulltext/2001/10190/clinical_perspectives_on_hiv_associated.3.aspx

  15. Shaw AJ, McLean KA, Evans BA. Disorders of fat distribution in HIV infection. Int J STD AIDS. 1998;9:595-599.

  16. Gervasoni C, Ridolfo AL, Triro G. Redistribution of body fat in HIV-infected women undergoing combined antiretroviral therapy. AIDS. 1999;13:465-71.

  17. Veny A, Bonjoch J, Romeu M. Cumulative risk for developing protease inhibitorassociated lipodystrophy (PI-AL) in HIV-infected patients. 38th Interscience Conference on Antimicrobial Agents and Chemotherapy. San Diego, September 1998 [abstract I-92]. Available from: http://www.thebody.com/content/art15486.html

  18. National Centre in HIV Epidemiology and Clinical Research. The University of New South Wales Sydney, Australia. [cited 2008 May 23]. Available from: http://www.nchecr.unsw.edu.au

  19. Carr A, Law M. An objective lipodystrophy severity grading scale derived from the lipodystrophy case definition score. JAIDS. 2003;33:571-6.

  20. Centers for Disease Control and Prevention. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults . MMWR Recomm Rep. 1992 Dec 18;41(RR-17):1-19. [cited 2008 May 20]. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm

  21. Tien C , Benson C, Zolopa AR, Sidney S, Osmond D, Grunfeld C. The Study of Fat Redistribution and Metabolic Change in HIV Infection (FRAM): Methods, Design, and Sample Characteristics. Am J Epidemiol 2006 May;163(9):860-9. [cited 2008 May 24]. Available from: http://aje.oxfordjournals.org/content/163/9/860.full.pdf+html

  22. Mallewa E et al HIV-associated lipodystrophy: a review of underlying mechanisms and therapeutic options. Journal of Antimicrobial Chemotherapy 2008;62:648-660. doi:10.1093 /jac/dkn251.

  23. Grunfeld C. Dyslipidemia and its treatment in HIV infection. Top HIV Med 2010; 18(3): 112-118. [cited 2010 Aug 23]. Available from: http://www.iasusa.org/pub/topics/2010/issue3/112.pdf




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Cubana Farm. 2012;46