Lipodystrophy and weight changes: data from the Swiss HIV Cohort Study, 2000-2006

Area of Science:

• HIV/AIDS research
• Pharmacology
• Clinical medicine

Background:

• Combination antiretroviral therapy (cART) regimens are evolving.
• Changes in cART may influence the occurrence and type of side effects.
• Lipodystrophy (LD) and weight changes are significant concerns in HIV treatment.

Purpose of the Study:

• To examine the frequency of lipodystrophy (LD) and weight changes.
• To assess the relationship between LD/weight changes and specific cART drugs.
• To analyze trends in cART drug usage and associated side effects in the Swiss HIV Cohort Study (SHCS).

Main Methods:

• Analysis of patient data from the Swiss HIV Cohort Study (SHCS) between 2000 and 2006.
• Inclusion of patients on cART during 2003-2006 and those initiating cART between 2000-2003.
• Physician-assessed scoring of 'fat accumulation', 'fat loss', or neither, with treatment details recorded.

Main Results:

• A decrease in the use of stavudine, didanosine, and nelfinavir from 2003-2006.
• Increased use of atazanavir and tenofovir.
• Patients starting cART in 2003-2006 showed a lower incidence of LD compared to 2000-2002 (P<0.02).
• LD was a less frequent reason for treatment change/discontinuation in 2006 versus 2003 (P for trend <0.001).
• Weight gain of >=5 kg was associated with lopinavir (OR 2) and atazanavir (OR 1.7).

Conclusions:

• Lipodystrophy (LD) has become less frequent in the SHCS cohort between 2000 and 2006.
• Weight gain exceeding 5 kg was significantly associated with the use of atazanavir and lopinavir.