Identifying patient characteristics associated with different phenotypic presentations of lipodystrophy among subjects with HIV
Objective: To determine the association between phenotypes of HIV associated lipodystrophy and various patient characteristics. Methods: Multicenter AIDS Cohort Study (MACS) is a large observational prospective study involving nearly 7,000 homosexual and bisexual men nationwide. We analyzed publicly available dataset of MACS cohort. Patients with lipodystrophy were identified and classified in to three phenotypes of lipodystrophy: lipoatrophy, lipohypertrophy, mixed disease or having no disease. Multinomial regression modeling was used to identify patient characteristics associated with different phenotypes of HIV associated lipodystrophy. Results: After evaluating the MACS cohort 1016 study participant, having seropositive status and necessary information available to determine lipodystrophy status were eligible for analysis. The proportion of patients having lipoatrophy, lipohypertrophy and mixed disease was 15%, 23% and 20% respectively. Our multivariable analysis revealed that lipoatrophy was significantly associated with age at the time of study entry, body mass index (BMI) at the time of study entry and ever use of Stavudine. Lipohypertrophy was significantly associated with the duration in the study, age at the time of study entry, low CD4 count (<200 cells>/mm3) and BMI at the time of study entry. Mixed disease was significantly associated with the duration in the study, age at the time of study entry, average triglyceride level across visits, BMI at the time of study entry, African American race and ever use of Stavudine and Efavirenz. Conclusion: Different patient characteristics are associated with different phenotypes of the HIV associated lipodystrophy. It appears that lipoatrophy and lipohypertrophy represents different disease processes and likely coexist or deteriorate over time to give rise to mixed disease. Empirical evidence will be required to confirm this hypothesis.
Gambhire, Dhiraj Devidas, "Identifying patient characteristics associated with different phenotypic presentations of lipodystrophy among subjects with HIV" (2014). Texas Medical Center Dissertations (via ProQuest). AAI1566322.