Biological Depiction of Lipodystrophy and Its Associated Challenges Among HIV AIDS Patients: Literature Review

Figures & data

Table 1 Studies Finding Showing Biological Depictions and Challenges Related to Lipodystrophy in AIDS Patients

Type of the Study	Country	Conducted by	Main Findings
Prevalence and risk actors
Cross-sectional	Serbia	Dragovi G et al, 2014^Citation9	The prevalence of lipodystrophy was 69.2%, NRTIs and protease were at high risk for lipodystrophy.
Cross-sectional	Brazil	Maria T et al, 2017^Citation20	The prevalence of lipodystrophy was 50.8%, and lipodystrophy was associated with excess weight and predisposes to the development of metabolic syndrome.
Cross-sectional	Nigeria	Iwuala SO et al, 2015^Citation21	The prevalence of lipodystrophy was 26%, and Male gender and HAART use were the factors associated with lipoatrophy.
Cross-sectional	India	Kalyanasundaram AP et al, 2012^Citation22	Among the patients on ART, the prevalence of lipodystrophy was 60.7%.
HAART regimen and lipodystrophy
Prospective Cohort	Thailand	Aurpibul L et al, 2012^Citation23	Substitution of stavudine with zidovudine resulted in decreased severity or resolution of lipodystrophy among HIV-infected children and adolescents.
Cross-sectional, comparative, descriptive study	Brazil	Tsuda LC et al, 2012^Citation24	Reported zidovudine, lamivudine and efavirenz seemed to protect against lipodystrophy syndrome.
Systematic review	Low economic countries	Finkelstein JL et al, 2015^Citation11	Nevirapine was associated with a 50% lower odds of lipoatrophy (OR 0.50, 95% CI: 0.26–0.95, <0.001).
Cross-sectional	India	Kalyanasundaram AP et al, 2012^Citation22	Lipodystrophy was reported in 62.1% of patients on ZDV regimens and 58.8% of patients on d4T regimens. There was no significant difference in the prevalence of lipodystrophy and type of ART in the study population.
Randomization trial	Uganda and Zimbabwe	Bwakura-dangarembizi M et al, 2015^Citation25	Long-term zidovudine-based ART is associated with similar body circumferences and skinfold thicknesses to abacavir-based ART with low rates of lipid abnormalities and clinical lipodystrophy.
Lipodystrophy related complication and modification of the syndrome
Cohort	Switzerland	Bouatou Y et al, 2 018^Citation26	About 24.9% of HIV patients on follow-up developed lipodystrophy during and is independently associated with chronic kidney disease (CKD) after adjustment for previously reported risk factors.
Cross-sectional	Democratic republic of Congo	Tshamala HK et al, 2019^Citation19	Lipohypertrophy, hypercholesterolemia, and lactic acidosis emerge as a frequent metabolic disorders in children and adolescents due to ARV therapy.
Cross-sectional	Brazil	Beraldo RA et al, 2017^Citation27	Lifestyle changes with nutritional follow-up, regular physical exercise, and a change in the therapeutic regimen may contribute to improve the metabolic profile and consequently reduce the cardiovascular risk of AIDS patients.
Cohort	USA	Safar Zadeh E et al, 2013^Citation28	Leptin replacement therapy ameliorated both the metabolic and hepatic abnormalities of lipodystrophy. Improvements in non-alcoholic steatohepatitis (NASH) score presumably represents stabilization or improvement of the course of the disease
Review		Nzuza S et al, 2017^Citation29	If lipodystrophy is not carefully managed, it may ultimately predispose a significant number of patients to increased risks of metabolic syndrome, diabetes and cardiovascular diseases.
Cross-sectional	Israel	Tsiodras S et al, 2019^Citation30	Adherence to a Mediterranean dietary pattern was favorably related to cardiovascular risk factors in HIV-positive patients with fat redistribution.
Challenges related to lipodystrophy
Review		Nzuza S et al, 2017^Citation29	Lipodystrophy related cosmetically distressing and socially stigmatizing for many patients leading to decreased adherence to antiretroviral therapy.
Cross-sectional and comparative	Brazil	Siqueira LR et al, 2021^Citation7	Lipodystrophy negatively affects the self-esteem of HIV infected people and this made it difficult to adhere to ART.
Cross-sectional	Burkina Faso	Guira O et al, 2014^Citation31	Facial lipoatrophy contributes more to stigma
Cross-sectional	Spain	Méndez ES et al, 2015^Citation32	About 27% of participants, who feared lipodystrophy, had poor adherence to treatment
Single-site cross-sectional	Switzerland	Verolet CM et al, 2015^Citation33	Lipodystrophy was associated with a poor quality of life among HIV AIDS patients on HAART.

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Bouatou Y, Ageron AG, Bernasconi E, et al. Development in HIV-Positive Patients in Switzerland: the LIPOKID Study. Kidney Int Reports. 2018;3(5):1089–1099. doi:10.1016/j.ekir.2018.04.014

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Tshamala HK, Aketi L, Tshibassu PM, et al. The Lipodystrophy Syndrome in HIV-Infected Children under Antiretroviral Therapy: a First Report from the Central Africa. Int J Pediatr. 2019;2019.

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Beraldo RA, Dos Santos AP, Guimarães MP, et al. Body fat redistribution and changes in lipid and glucose metabolism in people living with HIV/AIDS. Rev Bras Epidemiol. 2017;20(3):526–536. doi:10.1590/1980-5497201700030014

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Safar Zadeh E, Lungu AO, Cochran EK, et al. The liver diseases of lipodystrophy: the long-term effect of leptin treatment. J Hepatol. 2013;59(1):131–137. doi:10.1016/j.jhep.2013.02.007

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Nzuza S, Zondi S, Hurchund R. Highly Active Antiretroviral Therapy-Associated Metabolic Syndrome and Lipodystrophy. Pathophysiology and Current Therapeutic Interventions. 2017;7(4):103–116.

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Tsiodras S, Poulia K, Yannakoulia M, et al. Adherence to Mediterranean diet is favorably associated with metabolic parameters in HIV-positive patients with the highly active antiretroviral therapy – induced metabolic syndrome and lipodystrophy. Metabolism. 2009;58(6):854–859. doi:10.1016/j.metabol.2009.02.012

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Siqueira LR, Holanda G, Teresinha M, et al. Effect of lipodystrophy on self-esteem and adherence to antiretroviral therapy in people living with HIV. AIDS Care. 2021;1(1):1–10. doi:10.1080/09540121.2021.1936442

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Guira O, Tiéno H, Yaméogo B, et al. Characteristics and factors associated with the clinical forms of lipoatrophy during highly active antiretroviral therapy in Ouagadougou, Burkina Faso. J Int Assoc Provid AIDS Care. 2014;13(2):184–187. doi:10.1177/2325957413503369

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Verolet CM, Delhumeau-Cartier C, Sartori M, et al. Lipodystrophy among HIV-infected patients: a cross-sectional study on impact on quality of life and mental health disorders. AIDS Res Ther. 2015;12(1):1–10. doi:10.1186/s12981-015-0061-z

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