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Wiley InterScience

HIV Medicine

Volume 9 Issue 3, Pages 142 - 150

Published Online: 23 Jan 2008

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ORIGINAL RESEARCH

Lipodystrophy and weight changes: data from the Swiss HIV Cohort Study, 2000–2006

A Nguyen ¹ , A Calmy ¹ , V Schiffer ¹ , E Bernasconi ² , M Battegay ³ , M Opravil ⁴ , J-M Evison ⁵ , PE Tarr ⁶ , P Schmid ⁷ , T Perneger ⁸ , B Hirschel ¹ and the Swiss HIV Cohort Study

¹ Infectious Disease/HIV Unit, University Hospital Geneva, Geneva, Switzerland, ² Infectious Disease Service, Hospital Lugano, Lugano, Switzerland, ³ Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland, ⁴ Division of Infectious Diseases, University Hospital Zurich, Zurich, Switzerland, ⁵ Infectious Disease Service, University Hospital Bern, Bern, Switzerland, ⁶ Infectious Disease Service, University Hospital Lausanne, Lausanne, Switzerland, ⁷ Infectious Disease Unit, Hospital St-Gall, St-Gall, Switzerland and ⁸ Quality of Care Service, University Hospital Geneva, Geneva, Switzerland

Correspondence: Dr Alexandra Calmy, Division des Maladies infectieuses, Geneva University Hospital, rue Micheli-du-Crest 24, 1211 Genève 14, Switzerland. Tel: +41 22 3729808; fax: +41 22 3729599; e-mail: acalmy@gmail.com

^*All investigators are listed in the Appendix.

KEYWORDS

antiretroviral therapy • body weight • cohort studies • fat accumulation • fat loss • lipodystrophy • nonnucleoside reverse transcriptase inhibitors • nucleoside reverse transcriptase inhibitors • protease inhibitors • Swiss HIV Cohort Study

ABSTRACT

Background and Objectives

Combination antiretroviral therapy (cART) is changing, and this may affect the type and occurrence of side effects. We examined the frequency of lipodystrophy (LD) and weight changes in relation to the use of specific drugs in the Swiss HIV Cohort Study (SHCS).

Methods

In the SHCS, patients are followed twice a year and scored by the treating physician as having 'fat accumulation', 'fat loss', or neither. Treatments, and reasons for change thereof, are recorded. Our study sample included all patients treated with cART between 2003 and 2006 and, in addition, all patients who started cART between 2000 and 2003.

Results

From 2003 to 2006, the percentage of patients taking stavudine, didanosine and nelfinavir decreased, the percentage taking lopinavir, nevirapine and efavirenz remained stable, and the percentage taking atazanavir and tenofovir increased by 18.7 and 22.2%, respectively.

In life-table Kaplan–Meier analysis, patients starting cART in 2003–2006 were less likely to develop LD than those starting cART from 2000 to 2002 (P<0.02). LD was quoted as the reason for treatment change or discontinuation for 4% of patients on cART in 2003, and for 1% of patients treated in 2006 (P for trend <0.001). In univariate and multivariate regression analysis, patients with a weight gain of ≥5 kg were more likely to take lopinavir or atazanavir than patients without such a weight gain [odds ratio (OR) 2, 95% confidence interval (CI) 1.3–2.9, and OR 1.7, 95% CI 1.3–2.1, respectively].