Bioimpedance Evaluation of Body Fat Composition in Congolese HIV-Infected Patients under Antiretroviral Therapy Regimen Non-Containing Protease Inhibitors nor Stavudine

J. Makulo, Djuma Lukonga, A. Longo, Jean De Dieu Manyebwa, Trésor Monsere, E. Sumaili, H. Situakibanza, J. B. Kasiam, R. Mbungu, J. Kayembe, F. Lepira
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Abstract

Background: Protease inhibitors (PI) and stavudine are frequently associated with abnormalities of the body composition. The present study aimed to evaluate the body fat composition of HIV-infected Congolese patients receiving antiretroviral other than PI or stavudine. Patients and Methods: Anthropometric measures and body composition of 125 HIV-infected Congolese patients (average age 41 years, 76% women, 74% on antiretroviral therapy) attending a primary healthcare center was cross-sectionally evaluated. Patients receiving PI and/or stavudine were excluded. Subclinical abnormalities of body composition, evaluated by bioimpedance (BIA), were defined as elevated percentage of fat mass (FM) and perivisceral fat mass (PVF) and low percentage of total FM. Results: Clinically evaluated abnormalities of fat distribution were rarely seen, with any case of obesity or lipodystrophy. Overweight (16%) and central obesity (6.3%) were present only in a few women. BIA parameters of body fat composition were similar among antiretroviral naive and treated patients. An average higher percentage of FM (28% vs. 12.1%; p<0.001) and PVF (4.0% vs. 2.3%; p=0.002) were observed in women, with as well as a higher proportion of subjects with high levels of FM (12.6%) and PVF (2.2%) in the same group. Thinness was observed only in 6% of patients of whom 83.3% of men and 68.4% of women (p=0.059) had low levels of FM. Conclusion: Subclinical abnormalities of FM were present in these case series without clinically overt fat distribution abnormalities, highlighting the need for early detection of these FM abnormalities.
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不含蛋白酶抑制剂和司他夫定的抗逆转录病毒治疗方案下刚果hiv感染者体脂肪组成的生物阻抗评价
背景:蛋白酶抑制剂(PI)和司他夫定经常与身体成分异常有关。本研究旨在评估接受非PI或司他夫定抗逆转录病毒治疗的刚果艾滋病毒感染患者的体脂组成。患者和方法:对在初级卫生保健中心就诊的125名感染艾滋病毒的刚果患者(平均年龄41岁,76%为女性,74%接受抗逆转录病毒治疗)的人体测量测量和身体成分进行了横断面评估。排除了接受PI和/或司他夫定的患者。身体组成的亚临床异常,通过生物阻抗(BIA)评估,被定义为脂肪量(FM)和内脏周围脂肪量(PVF)百分比升高,总脂肪量百分比低。结果:临床评价的脂肪分布异常少见,无肥胖或脂肪营养不良病例。超重(16%)和中心性肥胖(6.3%)仅出现在少数女性中。未接受抗逆转录病毒治疗和治疗的患者体脂组成BIA参数相似。FM的平均比例更高(28% vs. 12.1%;p<0.001)和PVF (4.0% vs. 2.3%;p=0.002),在同一组中,高水平FM(12.6%)和PVF(2.2%)的比例更高。只有6%的患者消瘦,其中83.3%的男性和68.4%的女性(p=0.059)有低水平的FM。结论:在这些病例系列中存在亚临床的FM异常,但没有临床明显的脂肪分布异常,强调了早期发现这些FM异常的必要性。
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