Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
Eur Rev Med Pharmacol Sci. 2018 Mar;22(6):1852-1859. doi: 10.26355/eurrev_201803_14606.
We aimed to quantitatively evaluate body fat composition in a group of HIV patients treated with Highly Active Anti-retroviral Therapy (HAART) to ascertain both fat loss and fat distribution changes and to identify possible therapeutic and host related associated risk factors.
A total of 180 patients with available total body DEXA scan were assigned to a) Group 1, with clinically evident body fat changes, (BFC) and b) Group 2, without BFC. Clinical and immunovirologic data were collected. We used Student t-test and x2 or Fisher exact test to compare the characteristics of the two groups. Paired t-test was used to compare basal and follow-up data. The relationships between variables were evaluated by calculating Pearson's correlation coefficient and its significance.
HAART duration was significantly (p<0.0001) higher for patients in Group 1 than in Group 2, as well as PI (p<0.02) and NRTI (p<0.002) therapy duration. Current CD4 count and CD4 rise from nadir resulted significantly higher in Group 1 than in Group 2 (p<0.02 and 0.006, respectively). Whole Body Fat (WBF), Peripheral Fat (PF) and Leg (L) fat negatively correlated with PI and NRTI therapy duration, while Trunk Fat (TF)/PF positively correlated with PI and NNRTI duration. No significant correlation was found, instead, with NNRTI therapy duration. At 5-year follow-up, we registered a further increase in TF, Arms (A) and L fat, especially in PI-treated patients.
Body fat changes should always be considered when dealing with HIV-affected patients on HAART. The fat loss seemed to involve mainly peripheral regions, while fat accumulation tendency occurred in the trunk.
我们旨在通过对一组接受高效抗逆转录病毒疗法（HAART）治疗的 HIV 患者进行定量评估，以确定脂肪丢失和脂肪分布变化，并确定可能的治疗和宿主相关风险因素。
共对 180 名具有全身 DEXA 扫描的患者进行了研究，将他们分为 a）有临床明显体脂变化的组 1（BFC）和 b）无 BFC 的组 2。收集了临床和免疫病毒学数据。我们使用 Student t 检验和 x2 或 Fisher 精确检验比较两组的特征。使用配对 t 检验比较基础和随访数据。通过计算 Pearson 相关系数及其显著性来评估变量之间的关系。
与组 2 相比，组 1 中的患者接受 HAART 的时间明显更长（p<0.0001），PI（p<0.02）和 NRTI（p<0.002）治疗时间也更长。组 1 中的当前 CD4 计数和 CD4 计数从最低点升高显著高于组 2（p<0.02 和 0.006）。全身脂肪（WBF）、外周脂肪（PF）和腿部（L）脂肪与 PI 和 NRTI 治疗时间呈负相关，而躯干脂肪（TF）/PF 与 PI 和 NNRTI 治疗时间呈正相关。相反，与 NNRTI 治疗时间无明显相关性。在 5 年随访中，我们发现 TF、手臂（A）和 L 脂肪进一步增加，尤其是在接受 PI 治疗的患者中。
在处理接受 HAART 的 HIV 感染患者时，应始终考虑体脂变化。脂肪丢失似乎主要涉及外周区域，而脂肪堆积倾向于发生在躯干。
