Tien Phyllis C, Bacchetti Peter, Gripshover Barbara, Overton E Turner, Rimland David, Kotler Don
Department of Medicine, University of California San Francisco and Department of Veterans Affairs Medical Center, San Francisco, CA 94121, USA.
J Acquir Immune Defic Syndr. 2007 May 1;45(1):60-5. doi: 10.1097/QAI.0b013e3180423a95.
Coinfection with hepatitis C virus (HCV) is reported to be associated with a higher prevalence of lipodystrophy than HIV infection alone. We examine the association between HCV and adipose tissue volume in HIV-infected men and women.
Cross-sectional analysis of HIV-infected subjects from the study of Fat Redistribution and Metabolic Change in HIV Infection. MRI measured regional adipose tissue volume. Detectable HCV RNA defined HCV infection.
Twenty percent of 792 men and 26% of 329 women were HIV/HCV-coinfected. HIV/HCV-coinfected and HIV-monoinfected women had similar amounts of subcutaneous adipose tissue (SAT) in the leg, lower trunk, upper trunk, and arm and similar amounts of visceral adipose tissue (VAT). Similar findings were seen in men, except in the leg and VAT. After adjustment, HCV infection remained associated with more leg fat in men (12.2%, 95% confidence interval [CI]: 0.3 to 25.3; P = 0.043). Among those on stavudine, HIV-monoinfected men had less leg fat (-7% effect per year of stavudine use, 95% CI: -9 to -5; P < 0.001); a weaker association was seen in HIV/HCV-coinfected men (-2% effect, 95% CI: -7 to 3; P = 0.45). Indinavir was associated with less leg fat (-4% in HIV-monoinfected men, 95% CI: -6 to -1; P = 0.002; -5% in HIV/HCV-coinfected men, 95% CI: -11 to 2; P = 0.14).
Our findings suggest that HIV/HCV coinfection is not associated with less SAT in men and women. HCV infection seems to mitigate the loss of leg fat seen in HIV-infected men on stavudine.
据报道，丙型肝炎病毒（HCV）合并感染与脂肪代谢障碍的患病率高于单纯HIV感染。我们研究了HIV感染的男性和女性中HCV与脂肪组织体积之间的关联。
对来自HIV感染中的脂肪重新分布和代谢变化研究的HIV感染受试者进行横断面分析。MRI测量局部脂肪组织体积。可检测到的HCV RNA定义为HCV感染。
792名男性中有20%，329名女性中有26%为HIV/HCV合并感染。HIV/HCV合并感染和HIV单一感染的女性在腿部、下躯干、上躯干和手臂的皮下脂肪组织（SAT）量相似，内脏脂肪组织（VAT）量也相似。男性中也有类似发现，但腿部和VAT除外。调整后，HCV感染仍与男性腿部脂肪增多有关（12.2%，95%置信区间[CI]：0.3至25.3；P = 0.043）。在服用司他夫定的人群中，HIV单一感染的男性腿部脂肪较少（司他夫定使用每年的影响为-7%，95% CI：-9至-5；P < 0.001）；在HIV/HCV合并感染的男性中关联较弱（-2%的影响，95% CI：-7至3；P = 0.45）。茚地那韦与腿部脂肪减少有关（HIV单一感染的男性中为-4%，95% CI：-6至-1；P = 0.002；HIV/HCV合并感染的男性中为-5%，95% CI：-11至2；P = 0.14）。
我们的研究结果表明，HIV/HCV合并感染与男性和女性的SAT减少无关。HCV感染似乎减轻了服用司他夫定的HIV感染男性腿部脂肪的减少。
