Tien Phyllis C, Barrón Yolanda, Justman Jessica E, Hyman Charles, Cohen Mardge H, Young Mary, Kovacs Andrea, Cole Stephen R
Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
AIDS Patient Care STDS. 2007 May;21(5):297-305. doi: 10.1089/apc.2006.128.
We previously demonstrated that HIV infection is associated with peripheral and central lipoatrophy in women. We now describe the association of specific antiretroviral drugs (ARV) with body fat changes over a four-year period from 1999 to 2003. 775 HIV-positive and 205 HIV-negative women in the Women's Interagency HIV Study with anthropometric measurements, weight, bioelectric impedance analysis and ARV collected semiannually were included in analysis. Exposure to ARV was defined as report of use for 3 consecutive semiannual study visits. The average 6-month change in weight, percent total body fat, and circumference measurements (i.e., hip, waist, chest, arm, and thigh) was compared between those exposed and those unexposed to the specific ARV for any of the same three consecutive visits. Weight, percent total body fat, and hip, waist, thigh, chest, and arm circumferences decreased in HIV-positive women, but increased in HIV-negative women on average for every six-month interval over the 4-year study period. Among the HIV-positive women, didanosine was the only ARV associated with decreases in circumference measures in the hip (-0.65 cm, 95% confidence interval [CI]: -1.18, -0.12), waist (-0.71 cm, 95% CI: -1.37, -0.04), chest (-0.71 cm, 95% CI: -1.17, -0.26), and arm (-0.23 cm, 95% CI: -0.48, 0.03; p = 0.08). These prospective data suggest that fat loss continues to predominate in HIV-positive women and exposure to didanosine for at least 12 months may further worsen fat loss.
我们之前证明了HIV感染与女性外周和中枢性脂肪萎缩有关。我们现在描述1999年至2003年四年期间特定抗逆转录病毒药物（ARV）与身体脂肪变化之间的关联。女性机构间HIV研究中的775名HIV阳性和205名HIV阴性女性，她们每半年进行人体测量、体重、生物电阻抗分析并收集ARV使用情况，这些数据被纳入分析。ARV暴露定义为连续3次半年研究访视均报告使用该药物。比较在任何连续3次相同访视中暴露于特定ARV和未暴露于特定ARV的女性的体重、全身脂肪百分比和周长测量值（即臀部、腰部、胸部、手臂和大腿）的平均6个月变化。在4年研究期间，HIV阳性女性的体重、全身脂肪百分比以及臀部、腰部、大腿、胸部和手臂周长平均每6个月下降，但HIV阴性女性则增加。在HIV阳性女性中，去羟肌苷是唯一与臀部周长（-0.65厘米，95%置信区间[CI]：-1.18，-0.12）、腰部周长（-0.71厘米，95%CI：-1.37，-0.04）、胸部周长（-0.71厘米，95%CI：-1.17，-0.26）和手臂周长（-0.23厘米，95%CI：-0.48，0.03；p = 0.08）下降相关的ARV。这些前瞻性数据表明，HIV阳性女性中脂肪减少仍然占主导，暴露于去羟肌苷至少12个月可能会进一步加重脂肪减少。
