Lipodystrophy among AIDS patients: A preliminary report

Abstract

<b>Background</b> : Lipodystrophy (LD) is potentially stigmatizing and contributes to poor adherence to ­antiretroviral therapy. <b> Objectives</b> : To find out the prevalence and pattern of LD among <b> Acquired Immune Deficiency ^­ Syndrome</b> (AIDS) patients receiving Highly Active Antiretroviral Therapy (HAART), and to assess the ­psychological distress related to LD. <b> Materials and methods</b> : A cross-sectional study was designed after institutional ethical clearance and informed consent from 50 AIDS patients on HAART. Data collected were physical examination and response to a standardized questionnaire (Assessment of Body Changes and Distress questionnaire). They were analyzed using SPSS 14.0. <b> Results</b> : All subjects were on lamivudine, stavudine, and nevirapine (82%) or efavirenz (18%). The prevalence of LD was 28% (M = 5; F = 9) and ­significantly more among women (<i> P </i> = 0.019). The pattern of LD perceived by patients and assessed on physical examination were abdominal obesity in 50 and 38%, breast hypertrophy in 28 and 14%, wasting of buttocks in 22 and 26%, lipoatrophy of arms in 24 and 28%, and wasting of facial muscles in 20 and 32%, respectively. The overall perceived changes were 68%, while assessed were 62%. The body changes caused significant psychological distress to the patients (<i> P </i> = 0.001), although compliance was good. <b> Conclusion</b> : The study calls for early detection of LD and treatment or provision of alternative medicines and counseling of these patients, to reduce the physical and psychological burden.