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Prevalence of Metabolic Complications in a Large Diverse Cohort of HIV-Infected Persons W. M. EL-SADR*, G. COLLINS, S. RAGHAVAN, C. RAPPOPORT, C. GIBERT, A. CARR, and G. BARTSCH.
Community Programs for Clin. Res. on AIDS (CPCRA)
Background: A range of prevalence rates of various metabolic complications
of HIV or antiretroviral therapy (ART) has been reported. Uniformly collected
data on diverse populations and on both ART naive (ART/NAV) and ART experienced
(ART/EXP) patients (pts) are needed.
Methods: We evaluated all pts currently enrolled in CPCRA
studies and calculated (in both ART/NAV and ART/EXP) the percentages with
the following: diabetes mellitus (DM), coronary artery disease or stroke
(CAD/STRK), or body habitus change (BHC). BHC included any of: the following:
buffalo hump, peripheral lipodystrophy, increase in abdominal girth, and
breast enlargement. Multivariate analyses were done to determine independent
factors associated with each condition.
Results: A total of 1,370 pts (331 ART/NAV and 1039 ART/EXP) were
assessed, with a median age 40.2 years: 86% men, 34% African Americans,
12% Latino, 15% with a history of IDU, median CD4 348 cells/mm3
and median log HIV RNA 3.0 copies/ml.
Older age (P=0.001), non-whites (P=.06), higher CD4 count (P=.003) and
higher HIV RNA level (P=.02) were significantly associated with DM; older
age (P=.0001) was significantly associated with CAD/STRK; older age (P=0.005),
white race (P=0.001) and ART/EXP (P=.001) were significantly associated
with BHC. In the one study with data on duration of ART, white race (P=0.04)
and duration of ART (P=.0001) were significantly associated with BHC,
while protease inhibitor use was not.
Conclusions: Prevalence of BHC in this cohort was lower than reported
previously. Older age was associated with DM and CAD/STRK. BHC was reported
among ART/EXP but not among ART/NAV pts. White race and duration of ART
were associated with BHC while protease inhibitor use was not.
Key Words: body habitus change, HIV Therapy Compications, metabolic complications
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