Fat distribution in men with HIV infection

Area of Science:

• Endocrinology and Metabolism
• Infectious Diseases
• Medical Imaging

Background:

• HIV infection can cause changes in fat distribution, including peripheral fat loss and central fat gain.
• Understanding these changes is crucial for managing metabolic complications in HIV-positive individuals.

Purpose of the Study:

• To determine fat distribution changes specific to HIV infection by comparing HIV-positive men with control subjects.
• To investigate the associations between different adipose tissue depots in HIV-positive men.

Main Methods:

• Cross-sectional analysis comparing HIV-positive men and control men.
• Participant self-report and clinical examination to define lipoatrophy/lipohypertrophy.
• Magnetic resonance imaging (MRI) to measure regional adipose tissue volume (subcutaneous and visceral).

Main Results:

• HIV-positive men exhibited more peripheral and central fat loss (lipoatrophy) than controls.
• Peripheral lipoatrophy was significantly more common in HIV-positive men (38.3%) versus controls (4.6%).
• Central lipohypertrophy was less frequent in HIV-positive men (40.2%) compared to controls (55.9%).
• Peripheral lipoatrophy was not associated with increased visceral adipose tissue (VAT) in HIV-positive men.
• HIV-positive men with lipoatrophy had reduced subcutaneous adipose tissue (SAT) and VAT compared to HIV-positive men without lipoatrophy.
• Specific antiretroviral drugs (stavudine, indinavir, nevirapine) were associated with reduced SAT or VAT.

Conclusions:

• HIV infection is characterized by both peripheral and central subcutaneous lipoatrophy.
• Lipoatrophy in HIV-positive men is not linked to a reciprocal increase in visceral adipose tissue.
• Adipose tissue changes in HIV are complex and influenced by specific antiretroviral therapies.