Antiretroviral therapy associated lipodystrophy; learning from the past.

Background: With the introduction of effective antiretroviral therapy (ART), descriptions of body shape abnormalities, such as central fat accumulation and peripheral fat loss emerged among persons living with human immunodeficiency virus (HIV). We aimed to determine the prevalence of lipodystrophy and associated risk factors among patients on ART at Orotta National Referral Hospital (ONRH), Asmara, Eritrea. Methods: A single center, retrospective study was conducted at the ONRH, reviewing records of HIV-infected patients commenced on ART between January 2007 and December 2012. Results: Records of 250 eligible patients were reviewed. Most were female (59.2%, n=148) with a median age of 35 (IQR-20-63) years. Forty-three (17.2%) participants had body fat abnormalities. 42 (97.6%) had lipoatrophy and 1 (2.4%) buffalo hump. Of the 43 patients with lipodystrophy 34 (79%) were on Stavudine (d4T)/Lamivudine (3TC)/Nevirapine (NVP) regimen, 6 (14%) on Zidovudine (AZT)/3TC/NVP, 2 (4.7%) on d4T/3TC/Efavirenz (EFV) and 1(2.3%) on AZT, 3TC, EFV. EFV- based regimen was significantly associated with lipodystrophy (p< 0.01). Conclusion: We report a high prevalence of lipodystrophy. Four drug regimens were incriminated in the development of lipodystrophy. EFV-based regimen was significantly associated with the lipodystrophy.

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Changes in Lipid Profiles and Other Biochemical Parameters in HIV-1 Infected Patients Newly Commenced on HAART Regimen

Infectious Diseases Research and Treatment ◽

10.4137/idrt.s10044 ◽

2013 ◽

Vol 6 ◽

pp. IDRT.S10044 ◽

Cited By ~ 4

Author(s):

Ballah Akawu Denue ◽

Mohammed Bashir Alkali ◽

Ali Usman Abjah ◽

Ibrahim Musa Kida ◽

Babajide Ajayi ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Serum Lipid ◽

Biochemical Parameters ◽

Lipid Profiles ◽

Lipid Disorders ◽

Highly Active ◽

Immunodeficiency Virus ◽

High Prevalence ◽

Treatment Naïve

Abnormalities of lipid metabolism are common in human immunodeficiency virus (HIV)-infected patients and tend to be accentuated in those receiving antiretroviral therapy, particularly with protease inhibitors (PIs). However, there is a dearth of information on serum lipid profiles and biochemical parameters among treatment-naive HIV-positive patients in our environment. We found that after 24 months of highly active antiretroviral therapy (HAART), there was a significant increase in serum lipids. After 24 months of HAART, renal impairment was associated with a low increase in mean HDL and a high increase in triglycerides (TG). In conclusion, abnormality of serum lipid is common and showed female preponderance among treatment-naive HIV patients in our environment. Patients with HIV infection on HAART should be screened for lipid disorders given their high prevalence as observed in this study, because of its potential for morbidity and mortality in patients on HAART.

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The burden of neuropsychiatric disorders in patients living with HIV-1 treated with antiretroviral therapies—A perspective from US Medicaid data

International Journal of STD & AIDS ◽

10.1177/09564624211052884 ◽

2021 ◽

pp. 095646242110528

Author(s):

Wing Chow ◽

Hélène Hardy ◽

Ji Song ◽

Nancy Connolly ◽

Bingcao Wu

Keyword(s):

Antiretroviral Therapy ◽

Primary Outcome ◽

Neuropsychiatric Disorders ◽

Administrative Claims ◽

Art Initiation ◽

Immunodeficiency Virus ◽

High Prevalence ◽

The Mean ◽

Living With Hiv ◽

Hiv 1

Background People with human immunodeficiency virus (HIV)-1 face challenges with treatment adherence for various reasons, including consideration of neuropsychiatric disorders and neuropsychiatric adverse reactions associated with antiretroviral therapy (ART). Methods A retrospective cohort study was conducted using administrative claims data from the IBM MarketScan® Multi-State Medicaid Database (1/1/2014–12/31/2017). Adults (≥18 years) diagnosed with HIV-1 and newly initiated on antiretroviral therapy with continuous health plan enrollment were included. Primary outcome was the 6-month period prevalence of neuropsychiatric events (NPEs) of interest after ART initiation. Results Among 1971 newly treated patients included in the study, mean age (standard deviation [SD]) was 38.5 (12.7) years, and 41.4% were female. During the 6 months after ART initiation, 51.4% of patients had a claim for ≥1 NPE versus 30.3% of matched patients without HIV. Among newly treated patients, the most common (≥10%) NPE claims were for depression (42.2%), anxiety (15.8%), headache (11.9%), and bipolar/manic depression (10.1%). Also in this group, the mean (SD) total all-cause healthcare cost during the 6-month post-ART initiation was $16,632 ($33,928), of which $2914 ($18,233) was NPE-related. Conclusions In summary, in this Medicaid study of people newly initiated on ART, there was a high prevalence of NPEs, and incremental NPE-associated costs were considerable.

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