Lipodystrophy and Associated Factors In Haart Receiving HIV Subjects In Sodo Town, Ethiopia

Abstract

Ethiopia is one of the countries in Africa with a high prevalence of HIV/AIDS. Though the introduction of highly active antiretroviral therapy (HAART) improved survival and quality of life, early data from those treated, raised concerns about a possible increase in both peripheral and coronary arterial disease through lipodystrophy, diabetes mellitus and dyslipidemia. Hence an attempt was made in this study to assess the prevalence of lipodystrophy and to understand risk factors in HIV positive subjects receiving HAART. Study participants were men and women who were HIV/AIDS patients receiving HAART from Sodo government hospital, Southern Ethiopia. Data was collected on sociodemographic characteristics, HAART use, CD4 count, and subjects' status at the start of treatment, measure of body fat distribution and physical activity. In the present study the prevalence of moderate to severe clinical lipodystrophy in HIV-infected subjects receiving HAART for atleast 6 months was 15.9%, lipoatrophy was 9.1% and lipohypertrophy was 6.8%. Subjects who had been on HAART for 4 yrs or more, engaged in much lighter work intensity and who were underweight and overweight or obese had higher prevalence of lipodystrophy. In multivariate analysis, gender, duration of HAART, work intensity and recent BMI remained significantly associated with overall lipodystrophy. In multivariate analysis, for phenotypes of lipodystrophy, only work intensity remained significantly associated with lipoatrophy whereas work intensity and duration of HAART remained significantly associated with lipohypertrophy. Lipohypertrophy and lipoatrophy were positively associated with diabetes mellitus, while only lipohypertrophy was associated with hypertension. None of the HAART drugs or regimens were significantly associated with lipodystrophy and diabetes mellitus. Lipodystrophy syndrome has severe health consequences, as it may be responsible for stigma, reduced adherence to antiretroviral treatment, and increased risk of cardiovascular diseases.