Body fat changes in HIV patients on highly active antiretroviral therapy (HAART): a longitudinal DEXA study

Abstract. – OBJECTIVE: 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.
PATIENTS AND METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.