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达累斯萨拉姆接受护理和治疗诊所治疗的艾滋病毒感染患者中的脂肪代谢障碍。

Lipodystrophy among HIV-Infected Patients Attending Care and Treatment Clinics in Dar es Salaam.

作者信息

Njelekela Marina, Mpembeni Rose, Muhihi Alfa, Ulenga Nzovu, Aris Eric, Kakoko Deodatus

机构信息

Department of Physiology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.

Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.

出版信息

AIDS Res Treat. 2017;2017:3896539. doi: 10.1155/2017/3896539. Epub 2017 Oct 11.

Abstract

BACKGROUND

HIV infection and long-term HAART use are associated with metabolic and morphological changes. We assessed prevalence, types, and risk factors associated with lipodystrophy among HIV-infected adults attending CTC in Dar es Salaam, Tanzania.

METHODS

Analysis included 466 HIV-infected patients. Study protocol involved administration of structured questionnaire to collect sociodemographic and clinical information. Diagnosis of lipodystrophy was based on physician clinical assessment.

RESULTS

Lipodystrophy was present in 95 (20.4%) of the study participants, with lipoatrophy being the most common (49.5%) followed by mixed lipodystrophy (37.9%), and lipohypertrophy was the least prevalent (12.6%). Male gender, older age, long duration on HAART, and use of Stavudine containing regimen were associated with lipodystrophy (all < 0.05). The risk for lipodystrophy was 1.6 times (AOR = 1.66, 95% CI = 1.01-2.72) for male participants and 13.3 times (AOR = 13.3, 95% CI = 6.4-27.7) for those on HAART. Long duration on HAART and use of Stavudine containing regimen were also associated with increased risk for lipodystrophy. Lipodystrophy was associated with poor perception about own body image and decreased social interactions.

CONCLUSIONS

Lipodystrophy is common among HIV-infected patients in Tanzania, especially among male patients and those on HAART. Regular screening, monitoring, and patient awareness are needed for early identification and appropriate management.

摘要

背景

HIV感染及长期使用高效抗逆转录病毒治疗(HAART)与代谢和形态学改变相关。我们评估了在坦桑尼亚达累斯萨拉姆市接受综合治疗中心(CTC)治疗的HIV感染成人中脂肪代谢障碍的患病率、类型及相关危险因素。

方法

分析纳入了466例HIV感染患者。研究方案包括采用结构化问卷收集社会人口学和临床信息。脂肪代谢障碍的诊断基于医生的临床评估。

结果

95例(20.4%)研究参与者存在脂肪代谢障碍,其中脂肪萎缩最为常见(49.5%),其次是混合型脂肪代谢障碍(37.9%),脂肪增生最不常见(12.6%)。男性、年龄较大、HAART治疗时间长以及使用含司他夫定的治疗方案与脂肪代谢障碍相关(均P<0.05)。男性参与者发生脂肪代谢障碍的风险是1.6倍(调整后比值比[AOR]=1.66,95%置信区间[CI]=1.01 - 2.72),接受HAART治疗者的风险是13.3倍(AOR = 13.3,95%CI = 6.4 - 27.7)。HAART治疗时间长以及使用含司他夫定的治疗方案也与脂肪代谢障碍风险增加相关。脂肪代谢障碍与对自身身体形象的不良认知及社交互动减少有关。

结论

脂肪代谢障碍在坦桑尼亚的HIV感染患者中很常见,尤其是男性患者和接受HAART治疗的患者。需要进行定期筛查、监测并提高患者意识,以便早期识别和进行适当管理。

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