Antiretroviral therapy associated lipodystrophy; learning from the past

Abstract Background With the introduction of effective antiretroviral therapy (ART), descriptions of body shape abnormalities, such as central fat accumulation and peripheral fat loss emerged among persons living with human immunodeficiency virus (HIV). We aimed to determine the prevalence of lipodystrophy and associated risk factors among patients on ART at Orotta National Referral Hospital (ONRH), Asmara, Eritrea. Methods A single center, retrospective study was conducted at the ONRH, reviewing records of HIV-infected patients commenced on ART between January 2007 and December 2012. Results Records of 250 eligible patients were reviewed. Most were female (59.2%, n=148) with a median age of 35 (IQR-20-63) years. Forty-three (17.2%) participants had body fat abnormalities. 42 (97.6%) had lipoatrophy and 1 (2.4%) buffalo hump. Of the 43 patients with lipodystrophy 34 (79%) were on Stavudine (d4T)/Lamivudine (3TC)/Nevirapine (NVP) regimen, 6 (14%) on Zidovudine (AZT)/3TC/NVP, 2 (4.7%) on d4T/3TC/Efavirenz (EFV) and 1(2.3%) on AZT, 3TC, EFV. EFV-based regimen was significantly associated with lipodystrophy (p< 0.01). Conclusion We report a high prevalence of lipodystrophy. Four drug regimens were incriminated in the development of lipodystrophy. EFV-based regimen was significantly associated with the lipodystrophy.