Ongolo-Zogo P, Nkodo Mbia N, Mvogo Minkala T L, Biwole Sida M, Kouanfack C, Nko Amvene S
Hôpital central de Yaoundé, Yaoundé, Cameroun,
Bull Soc Pathol Exot. 2012 Dec;105(5):353-60. doi: 10.1007/s13149-012-0253-x. Epub 2012 Aug 10.
The association between sonographic liver steatosis and clinical lipodystrophy in AIDS patients treated by highly active antiretroviral therapy (HAART) has been studied. We conducted a cross-sectional study reviewing medical files of 117 AIDS patients followed up in Yaounde, Cameroon (6.3 F/1 M, mean age = 40 ± 9.4 years), and treated the patients with HAART protocol comprising stavudine or zidovudine for at least six months. All participants underwent abdominal ultrasonography and anthropometric assessment including body mass index (BMI). Data analysis included determining the association between sonographic liver steatosis, clinical lipodystrophy, and other clinical and biological data using the ¢(2) test, and the calculation of odd ratio. Fifty-one patients presented clinical lipodystrophy. The sonographic prevalence of hepatomegaly and splenomegaly was 70.1% and 25.6%, respectively. The overall prevalence of sonographic steatosis was 28.2%; specifically 37.3% among lipodystrophic patients and 21.1% among nonlipodystrophic patients (P = 0.03). According to the type of lipodystrophy, the prevalence was 40.6% among lipohypertrophic patients, 38.5% among lipodystrophic patients, and 16.7% among lipoatrophic patients. Clinical lipohypertrophy was statistically associated with a higher prevalence of sonographic steatosis (odd ratio = 2.5; 95% CI: [1.01-6.39], and P = 0.04). HAART protocol including stavudine was associated with lipodystrophy. The prevalence of sonographic liver steatosis is high among AIDS patients under HAART and is associated with lipohypertrophy.
已对接受高效抗逆转录病毒疗法(HAART)治疗的艾滋病患者的超声肝脏脂肪变性与临床脂肪营养不良之间的关联进行了研究。我们开展了一项横断面研究,回顾了喀麦隆雅温得接受随访的117例艾滋病患者的病历(6.3名女性/1名男性,平均年龄 = 40 ± 9.4岁),并采用包含司他夫定或齐多夫定的HAART方案对患者进行了至少六个月的治疗。所有参与者均接受了腹部超声检查和人体测量评估,包括体重指数(BMI)。数据分析包括使用卡方检验确定超声肝脏脂肪变性、临床脂肪营养不良与其他临床和生物学数据之间的关联,以及计算比值比。51例患者出现临床脂肪营养不良。肝脏肿大和脾肿大的超声患病率分别为70.1%和25.6%。超声脂肪变性的总体患病率为28.2%;具体而言,脂肪营养不良患者中为37.3%,非脂肪营养不良患者中为21.1%(P = 0.03)。根据脂肪营养不良的类型,脂肪肥厚患者中的患病率为40.6%,脂肪营养不良患者中为38.5%,脂肪萎缩患者中为16.7%。临床脂肪肥厚与超声脂肪变性的较高患病率在统计学上相关(比值比 = 2.5;95%可信区间:[1.01 - 6.39],P = 0.04)。包含司他夫定的HAART方案与脂肪营养不良相关。接受HAART治疗的艾滋病患者中超声肝脏脂肪变性的患病率较高,且与脂肪肥厚相关。