Risk factors for lipodystrophy in the CISAI cohort

Purpose. – This study set out to describe the frequency of lipodystrophy, and identify its risk factors, in HIV-positive patients treated with HAART containing at least one protease inhibitor (PI). We analyzed the data collected in the CISAI study. Method. – The CISAI is a multicenter cohort study that has enrolled 1480 patients. We assessed whether patients had lipodystrophy at a medical visit, with follow-up visits by the same physician at least every 2 months, and also on the basis of patients’ own reports. Results. – The lipodystrophy syndrome was detected in about 25% of the patients. Multivariate analysis showed the risk of lipodystrophy was correlated with female sex (RR 1.5; 95% confidence interval, CI, 1.2–2.1), with older age, with homosexuality (RR 1.5; 95% CI 1.0–2.4), with overt disease (RR 1.4; 95% CI 1.1–1.8) and with the duration of treatment before entering this study. The RR for ritonavir was higher than for the other PI (RR 1.4; 95% CI 0.9–1.9). Among patients receiving concomitant antiretroviral therapy the risk of lipodystrophy was greater with stavudine (RR 1.7; 95% CI 1.3–2.3). Conclusions. – The study confirmed the high frequency of the lipodystrophy syndrome among patients treated with PI.