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Session 90 Poster Session Incidence, Prevalence, and Pathogenic Correlates of Insulin Resistance and Lipodystrophy Syndrome Session Time: 4:30-6:30 pm Room 4E-F

684-T. Fat Redistribution in HIV Patients on Non-Protease Inhibitor (PI) Regimens- Study in 6 Centres in Nigeria S. Koko-Ekong*1, U. Azubike1, E. Ekong2, A. Uwah.3, and O. Akinlade2 1Shekomed AIDS/STD Control Organisation (SACO); 2Nigerian Army Reference Hosp., Yaba; and 3Central Publ. Health Lab., Yaba, Lagos, Nigeria Background: Fat redistribution, often ignored in patients on non-PI drug regimens, has a significant influence on quality of life, and greatly contributes to non-adherence, non-compliance, and choice of the drugs. The ojbjectives were to evaluate body changes in HIV-infected, PI-naïve patients receiving other antiretroviral drugs. Methods: Prospective, cross-sectional study of HIV-positive patients on PI-sparing regimens in 6 clinical centers in Nigeria. Questionnaires and focused group discussions were employed. Demographic data, drug history, social habits like smoking, alcohol consumption, physical activity, clinical and ART information were received from both patients and their physicians. Arm, waist, leg, and chest circumferences, and weight were assessed every 8 weeks from January 2000 to July 2001. Controls were 43 randomly selected patients who were ART naïve in the centres. Data was analysed using the SPSS software. Results: Total number of patients at inception were 87, 75% males; 75% were HIV-1-infected, 8% HIV-2, and 17% HIV-1 & 2. Drugs used included zidovudine (AZT), combivir (CBV), stavudine (d4T), lamivudine (3TC), didanosine (ddI), and zalcitabine (ddc). At the beginning, 25 (28.7%) patients were on AZT alone, while 56 (64.4%) were on CBV, and 17 (19.5%) on ddc. By week 12, 7 more patients in the CBV group commenced d4T, while 4 commenced ddc. Early changes in body shapes appeared after a mean period of 32 weeks. Facial fat wasting was the most commonly noticed change identified in 53 (46%) cases by 32 weeks. Increase: abdominal girth (11) (12.8%), breast (4) (4.3%), and buffalo hump (9) (10.5%) were first noticed at 36 weeks. At 40 weeks 2 patients on d4T reported signs of diabetes mellitus and peripheral neuropathy. Most of the fat wasting was in patients on d4T (66%), and ddc (56%). Increases were in patients on AZT (45%) and ddI (55%). Female patients had less fat wasting, and more increases especially buffalo hump and abdominal girth. Fewer changes were seen in HIVII patients. Some patients (20%) who experienced wasting reduced the doses of their drugs on their own. In the control group, there was generalized wasting in 78% as at 36 weeks. Conclusions: Fat redistribution is common in HIV-infected patients on PI-sparing regimens, even though wasting may be a feature of the disease state. This finding should be considered when counseling on the choice and acceptability of ART. The changes were less in HIV-2 patients.

©2002 9th Conference on Retroviruses and Opportunistic Infections