Researchers Develop Model for Lipodystrophy Case Definition for HIV-Positive Adults
Researchers involved with the HIV Lipodystrophy Case Definition Study Group have developed a model to diagnose lipodystrophy -- a "common and disfiguring" problem in which fat redistributes improperly in the body in patients taking antiretroviral therapy -- in HIV-positive adults, according to a study published in the March 1 issue of the Lancet. The researchers examined 1,081 HIV-positive patients over age 17 who had "no clinical signs of active AIDS" for four weeks before the beginning of the study. Participants were recruited at 32 sites around the world. Researchers divided the group between volunteers with at least one "moderate or severe subjective lipdystrophic feature" and participants with no such features, who served as controls. The researchers used the information to create a "broadly applicable" model for lipodystrophy case definition, including 10 variables. The model includes age, sex, duration of HIV infection, HIV "disease stage," waist to hip ratio, anion gap, the amount of HDL cholesterol in the blood, trunk to peripheral fat ratio, percentage leg fat and "intra-abdominal to extra-abdominal fat ratio." Although the model contains 10 parameters, it is "no more complex" than similar models created for rheumatological disease studies, the researchers said. They concluded that using the model in HIV research will "allow for more reliable estimates" of lipodystrophy prevalence, incidence, cause and responses to prevention and treatment, adding, "Our study serves as a model for the development of objective measures for other common, subjectively defined, adverse events associated with antiretroviral treatment." The researchers also said that further research was needed to determine if the connections between any of the symptoms are "direct or indirect" with lipodystrophy and if the case definition changes when applied to children (Carr et al., Lancet, 3/1).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.