Brown Todd T, Chu Haitao, Wang Zhaojie, Palella Frank J, Kingsley Lawrence, Witt Mallory D, Dobs Adrian S
Division of Endocrinology and Metabolism, Johns Hopkins University, 1830 East Monument Street, Baltimore, MD 21287, USA.
AIDS. 2007 Aug 20;21(13):1731-8. doi: 10.1097/QAD.0b013e328270356a.
The relative contributions of the different classes of antiretroviral therapy (ART), HIV infection per se, and aging to body shape changes in HIV-infected patients have not been clearly defined in longitudinal studies.
Since September 1999, men enrolled in the Multicenter AIDS Cohort Study have undergone measurements of body mass index (BMI) and body circumferences at each semi-annual visit. The effect of HIV-serostatus and cumulative exposure to the three major ART classes on changes in anthropomorphic measurements occurring between 1999 and 2004 among HIV-infected and HIV-uninfected men were determined using linear mixed effects regression models.
At baseline, average BMI and circumference measurements were greater in HIV-uninfected men (n = 392) than HIV-infected men (n = 661) (BMI, 27.3 versus 25.3 kg/m; waist, 96.4 versus 90.2 cm; hip 101.3 versus 95 cm, thigh 54.1 versus 50.8 cm; arm 33.3 versus 31.7 cm, P < 0.001 for each comparison). Cumulative nucleoside reverse transcriptase inhibitor (NRTI) exposure, but not protease inhibitor or non-nucleoside reverse transcriptase inhibitor exposure, was associated with statistically significant changes in BMI (-0.11 +/- 0.04 kg/m per year) and in circumferences of waist (-0.27 +/- 0.07 cm/year), hip (-0.24 +/- 0.05 cm/year), and thigh (-0.16 +/- 0.03 cm/year) over the 5 years of follow-up. Independent of ART exposure, HIV-infected men had a more rapid increase in waist circumference over the study interval than did the HIV-uninfected men (difference 0.33 +/- 0.15 cm/year, P = 0.02).
Cumulative NRTI therapy was associated with longitudinal decreases in body circumference measurements, whereas HIV-serostatus was associated with increases in waist circumference independent of ART.
在纵向研究中，不同类别的抗逆转录病毒疗法（ART）、HIV感染本身以及衰老对HIV感染患者身体形态变化的相对贡献尚未明确界定。
自1999年9月起，参与多中心艾滋病队列研究的男性在每次半年随访时均接受体重指数（BMI）和身体周长测量。使用线性混合效应回归模型确定HIV血清状态以及累积暴露于三大类ART对1999年至2004年间HIV感染和未感染男性人体测量变化的影响。
在基线时，未感染HIV的男性（n = 392）的平均BMI和周长测量值高于感染HIV的男性（n = 661）（BMI，27.3对25.3kg/m；腰围，96.4对90.2cm；臀围101.3对95cm，大腿围54.1对50.8cm；上臂围33.3对31.7cm，每项比较P < 0.001）。在5年的随访中，累积核苷类逆转录酶抑制剂（NRTI）暴露与BMI（每年-0.11 +/- 0.04kg/m）以及腰围（每年-0.27 +/- 0.07cm）、臀围（每年-0.24 +/- 0.05cm）和大腿围（每年-0.16 +/- 0.03cm）的统计学显著变化相关，但蛋白酶抑制剂或非核苷类逆转录酶抑制剂暴露则不然。独立于ART暴露，在研究期间，感染HIV的男性腰围的增加速度比未感染HIV的男性更快（差异为每年0.33 +/- 0.15cm，P = 0.02）。
累积NRTI治疗与身体周长测量值的纵向下降相关，而HIV血清状态与独立于ART的腰围增加相关。
