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Updated: Sep 27, 2026
Isolation, Expansion, and Adipogenic Induction of CD34+CD31+ Endothelial Cells from Human Omental and Subcutaneous Adipose Tissue
Published on: July 17, 2018
Relationship between HAART adherence and adipose tissue alterations
Adriana Ammassari1, Andrea Antinori, Alessandro Cozzi-Lepri
1Clinica delle Malattie Infettive, Università Cattolica del S. Cuore, Roma, Italy. aammassari@libero.it
Insights
Adherence to highly active antiretroviral therapy (HAART) can lead to adipose tissue alterations (ATA). Patient-perceived ATA may decrease HAART adherence, highlighting a complex interplay impacting treatment outcomes.
Area of Science:
- HIV/AIDS research
- Pharmacology
- Metabolic disorders
Background:
- Adipose tissue alterations (ATA) are common in patients on highly active antiretroviral therapy (HAART).
- ATA can negatively impact quality of life and adherence to HAART.
- Previous studies were cross-sectional, limiting causal inference.
Purpose of the Study:
- To evaluate the longitudinal relationship between ATA and adherence to HAART.
- To investigate the bidirectional interaction between ATA and HAART adherence over time.
Main Methods:
- Longitudinal analysis of participants from the Italian Cohort Naive Antiretrovirals (ICoNA) substudies (AdICoNA and LipolCoNA).
- Adherence assessed via a 16-item self-administered questionnaire.
- ATA diagnosed by physicians and self-perceived by patients; both evaluated longitudinally.
Main Results:
- Good baseline adherence increased the likelihood of developing ATA (RH = 2.58).
- Self-perceived ATA at baseline was a significant predictor of subsequent nonadherence (OR, 4.67).
- Clinically diagnosed ATA was not significantly associated with future nonadherence (OR, 0.77).
Conclusions:
- HAART adherence and ATA exhibit a dynamic, interactive relationship.
- Higher adherence may increase the risk of developing ATA.
- Patient-reported ATA can negatively affect subsequent HAART adherence.
Abstract:
Adipose tissue alterations (ATA), which are common among persons treated with highly active antiretroviral therapy (HAART), can have substantial psychologic repercussions, with a subsequent negative impact on the patient's quality of life and on HAART adherence. However, the cross-sectional nature of the studies precludes establishing the direction and causality of the relationship. The authors evaluated the longitudinal relationship between ATA and adherence to HAART. The analysis included all participants in the AdICoNA and the LipolCoNA substudies of the Italian Cohort Naive Antiretrovirals (ICoNA). Adherence was assessed using a 16-item self-administered questionnaire, which also included a question on self-perceived fat accumulation experienced during the past 4 weeks. ATA was diagnosed by physicians at enrollment and evaluated every 6 months thereafter. There were 207 patients, with a median age of 35 years; 73% were men; and 34% acquired HIV through injection drug use. At baseline, nonadherence was reported by 63% of participants, and ATA was self-perceived by 15% and clinically diagnosed in 25%. Using Cox regression analysis, patients with good adherence at baseline were more likely to develop ATA (RH = 2.58; 95% CI, 1.09-6.11) and developed it sooner. Self-perceived ATA at baseline was independently related to subsequent nonadherence (OR, 4.67; 95% CI, 1.01-22.4), but clinically diagnosed ATA was not (OR, 0.77; 95% CI, 0.37-1.61). Patients' adherence to HAART is a dynamic process that interacts with ATA. Better adherence is associated with a higher risk of subsequent occurrence of ATA, while patient-perceived onset of morphologic alterations can reduce adherence to antiretroviral therapy.
