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Title: Effect of different antiretroviral drug regimens on body fat distribution of HIV-infected South African women
Authors: Goedecke, Julia H. 
Micklesfield, Lisa K. 
Lambert, Estelle Victoria 
Levitt, Naomi Sharlene 
West, Sacha Jane 
Maartens, Gary 
Dave, Joel Alex Lex 
Keywords: Absorptiometry;Anthropometry;Anti-retroviral agents;HIV-positive persons -- Health and hygiene;Body composition
Issue Date: 1-Jan-2013
Publisher: Mary Ann Liebert
Source: Goedecke, J. H.; Micklesfield, L. K.; Levitt, N.; Lambert, E. V.; West,S.J.; Maartens, G. & Dave, J.A.L. 2013. Effect of different antiretroviral drug regimens on body fat distribution of HIV-infected South African women, AIDS Research and Human Retroviruses. 29(3), 2013: 557-563, March [10.1089/aid.2012.0252]
Journal: AIDS Research and Human Retroviruses 
Abstract: No African studies have examined the effect of first-line nonnucleoside reverse transcriptase inhibitor (NNRTI)-based and second-line protease inhibitor (PI)-based antiretroviral therapy (ART) on body composition. We compared body composition in HIV-infected black South African women receiving NNRTI-based ART (ART1, n=344), PI-based ART (ART2, n=91), and those not on ART (ART-naive, n=309). Accordingly, body composition was measured using dual energy x-ray absorptiometry (DXA) and anthropometry in a cross-sectional study. Despite similar body mass index (BMI), ART1 and ART2 had greater central fat mass (FM) [median (IQR): 44.2 (39.4-50.1) and 46.9 (39.3-52.8) vs. 41.1 (36.3-45.2) %FM, p<0.01] and less leg FM [41.2 (34.8-45.8) and 40.2 (32.9-45.7) vs. 43.9 (39.3-48.1) %FM, p<0.01] than ART-naive women. Within ART1, waist:hip was greater [0.87 (0.81-0.92) vs. 0.84 (0.78-0.89), p=0.006], while calf skinfold was lower [15.2 (9.4-21.5) vs. 17.4 (12.0-23.6) mm, p=0.033] in women receiving efavirenz compared to nevirapine. ART2 had a greater waist:hip, and abdominal, subscapular, and suprailiac skinfolds than ART1 (p<0.05). After adjusting for time on d4T (stavudine), ART2 had greater body fat than ART1 (p<0.05). With increasing time on d4T, the decrease in leg fat (%FM) was higher in ART1 than ART2 (p=0.012, for time×treatment effect). A similar interaction was reported for total time on ART treatment (p=0.002 for time×treatment effect). In conclusion, ART was associated with increased central fat and reduced peripheral fat. Changing to a PI-based regimen in ART2, which also substitutes stavudine with zidovudine, partially reversed the peripheral fat loss observed on ART1.
ISSN: 0889-2229
1931-8405 (e-)
DOI: 10.1089/aid.2012.0252
Appears in Collections:BUS - Journal Articles (DHET subsidised)

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