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Prevalence of and risk factors for lipodystrophy among HIV-infected patients receiving combined antiretroviral treatment in the Asia-Pacific region: results from the TREAT Asia HIV Observational Database (TAHOD).

Authors
 Sang Hoon Han ; Jialun Zhou ; Jun Yong Choi ; Matthew G Law ; Tuti Parwati Merati ; Fujie Zhang ; Vonthanak Saphonn ; Shinichi Oka ; Patrick CK Li ; Sanjay Pujari ; Christopher KC Lee ; Somnuek Sungkanuparph ; Thira Sirisanthana ; Yi-Ming A Chen ; Nittaya Phanuphak ; Sasheela Vanar ; Suneeta Saghayam 
Citation
 Endocrine Journal, Vol.58(6) : 475~484, 2011 
Journal Title
 Endocrine Journal 
ISSN
 0918-8959 
Issue Date
2011
Abstract
The prevalence of and risk factors for lipodystrophy (LD) among patients receiving combined antiretroviral treatment (cART) in the Asia-Pacific region are largely unknown. LD diagnosis was based on the adverse event definition from the US NIH Division of AIDS (2004 version), and only cases with a severity grade of ≥ 3 were included. TAHOD patients who had recently commenced cART with ≥ 3 drugs after 1996 from sites which had ever reported LD were included in the analysis. Covariates for the forward multivariate logistic regression model included demographic variables, CDC disease classification, baseline CD4 and viral load, hepatitis B/C virus co-infection, and regimen and duration of cART. LD was diagnosed in 217 (10.5%) of 2072 patients. The median duration of cART was 3.8 (interquartile range, 2.2-5.3) years [stavudine, 2.0 (1.0-3.5) years; zidovudine, 1.8 (0.6-3.9) years; and protease inhibitors (PI), 2.6 (1.3-4.5) years]. In the multivariate model, factors independently associated with LD included use of stavudine (≤ 2 years vs. no experience: OR 25.46, p<0.001, > 2 years vs. no experience: OR 14.92, p<0.001), use of PI (> 2.6 years vs. no experience: OR 0.26, p<0.001), and total duration of cART (> vs. ≤ 3.8 years: OR 4.84, p<0.001). The use of stavudine was strongly associated with LD in our cohort. Stavudine-sparing cART strategies are warranted to prevent the occurrence of LD in the Asia-Pacific region.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93702
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
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