Prevalence of Lipodystrophy and Dyslipidemia among Patients with HIV Infection on Generic ART in Rural South India
|
|
- Oscar Bradley
- 5 years ago
- Views:
Transcription
1 Prevalence of Lipodystrophy and Dyslipidemia among Patients with HIV Infection on Generic ART in Rural South India Journal of the International Association of Physicians in AIDS Care 11(5) ª The Author(s) 2012 Reprints and permission: sagepub.com/journalspermissions.nav DOI: / Annie Phoebe Kalyanasundaram, PhD 1, Saramma Mini Jacob, MD 1, Ramachandran Hemalatha, MSc 2, and Mampakkam Rajappa Sivakumar, DM 1 Abstract As antiretroviral therapy (ART) becomes more available to the HIV-infected population, it is important to determine the prevalence of its long-term complications. In this cross-sectional study, 145 HIV-positive patients on ART, 146 HIV-positive patients not on ART, and 72 HIV-negative individuals visiting the Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited from February 2007 to April Among the patients on ART, the prevalence of lipodystrophy was 60.7%; 22.7% with lipohypertrophy, 51.1% with lipoatrophy, and 22.7% with mixed pattern. The proportion of patients with dyslipidemia was significantly higher in the treatment group when compared to ART-naive and HIV-negative controls (P ¼.00). Total duration of ART was significantly associated with lipodystrophy (P ¼.04) and dyslipidemia (P ¼.01). Also, by logistic regression, abnormal metabolic levels were a risk factor in lipodystrophy (P ¼.02). This study highlights the need for development of inexpensive and accessible treatments for the reduction of lipodystrophy. Keywords ART, dyslipidemia, HIV/AIDS, lipodystrophy, Namakkal Introduction The introduction of highly active antiretroviral therapy (HAART) has led to a significant reduction in AIDS-related morbidity and mortality. 1 Abnormalities in fat distribution (lipodystrophy), insulin resistance and diabetes, dyslipidemia, hyperlactatemia, osteopinea, and osteonecrosis are some of the morphologic and metabolic complications of long-term HAART use. 2,3 Lipodystrophy is characterized by fat loss (lipoatrophy) in the face, arms, buttocks, and legs; or/and fat gain (lipohypertrophy) in the abdomen and breasts, as well as over the back of the neck ( buffalo hump"). 4 The morphological changes are potentially stigmatizing, resulting in poor adherence to antiretroviral therapy (ART) and hence treatment failure. 5 Lipodystrophy associated with long-term HAART use has been widely described in the developed world. 4,6 Such data are limited in India and is confined to tertiary HIV care centers in urban areas As ART becomes more available to the HIVinfected population in rural areas, it is important to determine the prevalence of its complications in these areas. Therefore, it was proposed to find out the prevalence of lipodystrophy among patients receiving ART in rural South India. The prevalence of dyslipidemia in patients receiving ART compared to HIV-positive ART-naive and HIV-negative adults in this population was also studied. Material and Methods Study Population In this cross-sectional study, HIV-infected patients on ART, visiting the ART center at Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited from February 2007 to April They were on generic first-line fixeddose combinations of ART, provided for free by the Indian Government under its national ART program. HIV-positive individuals visiting the ART center for ART screening, and follow-up clinics at the Prevention of Mother to Child Transmission (PMTCT) centers in Namakkal District served as the first comparison group. There was a second comparison group of healthy HIV-negative adults who had accompanied the HIV-positive patients. All the participants were aged 18 years or above. Written informed consent was obtained from all the 1 Department of Experimental Medicine, The Tamil Nadu Dr MGR Medical University, Chennai, India 2 Department of Oral Pathology, Ragas Dental College, Chennai, India Corresponding Author: Saramma Mini Jacob, Department of Experimental Medicine, The Tamil Nadu Dr MGR Medical University, No. 69, Anna Salai, Guindy, Chennai , India saramini@yahoo.com
2 330 Journal of the International Association of Physicians in AIDS Care 11(5) participants. The exclusion criteria for all the participants were active substance or alcohol abuse, current usage of anabolic steroids, glucocorticoids, lipid-lowering or hypoglycemic drugs, recent opportunistic infection, or malignancy. Assessments and Measurements Sociodemographic information, anthropometric measurements, and details of type and duration of ART regimen were recorded. Patients self-perception of lipodystrophy (lipohypertrophy and lipoatrophy) was obtained using standardized questionnaires and clinically confirmed by the physician at the ART center. Lipoatrophy was defined as facial fat loss, peripheral fat loss on arms, legs, or buttocks. Lipohypertrophy was defined as central fat gain on upper back, chest, or abdomen. The questionnaire was administered in the local language (Tamil), which was spoken by all patients. The questionnaire was explained in detail to the patients to ensure all participants understood the requirements. Anthropometric measurements included body weight (kg), height (cm), waist circumference (cm), and hip circumference (cm). Participants were weighed wearing light clothing and without shoes to the nearest 0.1 kg. Height was measured to the nearest millimeter using a stadiometer, the participant not wearing shoes. Body mass index (BMI, weight in kg divided by the square of the height in m) was calculated. Waist circumference to the nearest millimeter was measured using a cloth tape measure halfway between the lowest rib and the iliac crest. Hip circumference to the nearest millimeter was measured at the level of the anterior superior iliac spine when this could be palpated; otherwise, it was measured at the broadest circumference below the waist. The waist-to-hip ratio (WHR) was calculated from these measures. The CD4 counts before initiation of therapy was recorded for patients on therapy. Current CD4 counts were recorded for all the HIV-infected patients. An overnight fasting blood was drawn to determine serum lipids levels. Aliquots of serum were stored at 80 C. Total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides were analyzed by colorimetric enzymatic methods with reagents purchased from Identii (Spain) using Stat Fax 3300 chemistry analyzer (Awareness Technology, USA). Low-density lipoprotein (LDL) cholesterol and very low density lipoprotein (VLDL) cholesterol was calculated using the Friedewald formula. 11 Dyslipidemia was defined as total cholesterol 200 mg/dl, HDL-cholesterol 40mg/dL, LDL-cholesterol 130 mg/dl, and triglycerides 150 mg/dl by the US National Cholesterol Education Program (NCEP) III guidelines. 12 Statistical Analysis Data entry and Database management was completed using Microsoft Office Excel Statistical analyses were done using Statistical Package for Social Sciences (SPSS) Version Descriptive statistics were presented for all variables. Association between characteristics (age, gender, literacy, habit, and BMI classification) and prevalence of abnormal metabolic levels of the study groups was compared by chisquare test. ANOVA test was used to compare the mean anthropometric measurements, biochemical, and immunological values between the study groups, if the data was normally distributed. Multiple comparisons were made by post hoc test Bonferroni pair-wise comparison. For nonnormal data comparisons, Kruskal-Wallis Nonparametric test was used. For normally distributed data, linear association between any 2 variables was determined by Pearson correlation. In the case of nonnormal data, nonparametric measure of correlation, Spearman correlation coefficient was used. Both univariate and multivariate logistic regression analysis was done to see the risk factor for ART regimen, abnormal metabolic levels, lipodystrophy and lipoatrophy. A P value of <.05 was considered statistically significant. Results Total number of participants enrolled in the study was 363, with 196 (54%) females and 167 (46%) males. Three groups were studied: (1) 145 HIV-infected participants (46.9% males, 53.1% females) currently receiving ART for a mean 29.4 months (range, 2 to 60 months) with number of patients on zidovudine (ZDV)/lamivudine (3TC)/nevirapine (NVP), and AZT/3TC/efavirenz (EFV) regimens being 54 (37.8%) and4(2.8%), respectively, while those on stavudine (d4t)/ 3TC/NVP and d4t/3tc/efv regimens were 83 (58%) and 2(1.4%), respectively; (2) 146 ART-naive patients; and (3) 72 HIV-negative controls. Because of fat distribution concerns, 17 patients previously on d4t regimen had been switched to ZDV regimen. Mean age was years and mean BMI was kg/m 2. The mean CD4 count was /mLat the initiation of therapy in patients on ART. ART-naive patients had lower mean CD4 counts (most recent) as compared to patients on ART ( vs ; P ¼.00). There was no difference in gender distribution among the 3 groups and no difference in mean age among patients on ART and HIV-negative controls. However, HIV-infected patients who were ART-naive were younger than those on ART (P ¼.00) and HIV-negative controls (P ¼.048; Table 1). Anthropometric Characteristics Patients on ART had higher mean BMI (P ¼.00) as compared to ART-naive patients but lower mean BMI (P ¼.00) as compared to HIV-negative controls (Table 1). Moreover, a higher percentage of patients on ART (18.1%) were significantly underweight (BMI <18.5 kg/m 2 ) when compared to HIVnegative controls (5.5%), with ART-naive patients being the most underweight (38.8%; P ¼.00).Severely underweight patients (BMI <16.5 kg/m 2 ) were also of a significantly higher percentage among HIV-infected patients (ART ¼ 3.5%, ARTnaive ¼ 11.5%, HIV-negative ¼ 1.4%; P ¼.00).
3 Kalyanasundaram et al 331 Table 1. Characteristics of Study Participants a Variable HIV-Infected on ART (n ¼ 145) HIV-Infected ART-Naive (n ¼ 146) HIV-Negative (n ¼ 72) Sex (% male) Age (years) b,c Body mass index (kg/m 2 ) b,c,d Waist hip ratio b,c CD4 count (/ml) b NA Total cholesterol (mg/dl) b,c,d HDL-cholesterol (mg/dl) b,c,d Total-C/HDL-C LDL-cholesterol (mg/dl) b VLDL-cholesterol (mg/dl) b,c Triglycerides (mg/dl) b,c a Values are the Mean + SD for continuous variables unless otherwise indicated. Mean values with standard deviations are given. b Significant difference among patients on ART and ART-naive (P <.05). c Significant difference among patients on ART-naive and HIV-negative (P <.05). d Significant difference among patients on ART and HIV-negative (P <.05). Abbreviation: NA, not applicable. Table 2. Prevalence of Dyslipidemia Parameters HIV-Infected on ART (n ¼ 145) n (%) HIV-Infected ART-Naive (n ¼ 146) n (%) HIV-Negative (n ¼ 72) n (%) P Value a Total cholesterol 200 mg/dl 56 (38.6) 6 (4.1) 12 (16.7).00 HDL-Cholesterol 40 mg/dl 36 (24.8) 107 (73.3) 29 (40.3).00 LDL-Cholesterol 130 mg/dl 45 (31.0) 9 (6.2) 11 (15.3).00 VLDL-cholesterol 500 mg/dl (no patients) Triglycerides 150 mg/dl 61 (42.1) 10 (6.8) 15 (20.8).00 Cholesterol/HDL 6.5 mg/dl 16 (11.9) 19 (13) 4 (5.6).244 a Pearson chi-square. Lipodystrophy Among the patients on ART, the prevalence of lipodystrophy was 60.7%; 22.7% with lipohypertrophy, 51.1% with lipoatrophy, and 22.7% with mixed pattern. There was a significant difference in lipodystrophy pattern between females and males, with females having a higher prevalence (62.5% vs 37.5%; P ¼.004). Prevalence of lipoatrophy was also higher in females (68.9% vs 31.1%; P ¼.015). Moreover, there was a higher prevalence of facial atrophy among women compared to men (68.8% vs 31.2%; P ¼.029). There was no significant difference in the prevalence of lipodystrophy and type of ART in this study population. Lipodystrophy was reported in 62.1% of patients currently on ZDV regimens and 58.8% of patients currently on d4t regimens. Lipoatrophy was documented in 34.5% of patients currently on ZDV and 29.4% of patients currently on d4t regimens. Because of fat distribution concerns, 17 patients previously on d4t regimen had been switched to ZDV regimen. There was a higher prevalence of lipoatrophy among all patients currently or previously receiving d4t regimens as compared to those receiving ZDV regimens only, but it was not significant (33.7% vs 26.85%; P ¼.85). Among all the patients with lipodystrophy, 70.9% received or had received d4t. Also, 75.6% of all participants with lipoatrophy, 63.2% with mixed pattern, and 65% with lipohypertrophy, received or had received d4t. Moreover, 55.4% of patients who had ever received d4t had facial atrophy. Total duration of ART was significantly associated with lipodystrophy, with 7.1%, 37.6%, and 55.3% of patients having developed lipodystrophy within 1 year, 1 to 2 years, and more than 2 years, respectively, of initiating ART (P ¼.04). However, even though participants with lipodystrophy had higher mean duration (months) of therapy compared to those without lipodystrophy ( vs , P ¼.219), there was no significance. Dyslipidemia Patients on ART had significantly higher mean total cholesterol (P ¼.00), HDL-cholesterol (P ¼.00), LDL-cholesterol (P ¼.00), VLDL-cholesterol (P ¼.00), and triglycerides (P ¼.00), when compared to ART-naive patients and higher total cholesterol (P ¼.00), HDL-cholesterol (P ¼.003), VLDLcholesterol (P ¼.012), and triglycerides (P ¼.007), when compared to HIV-negative controls (Table 1). As seen in Table 2, the proportion of patients with dyslipidemia according to NCEP III guidelines was significantly higher in the treatment group when compared to ART-naive and HIV-negative controls except for the proportion of
4 332 Journal of the International Association of Physicians in AIDS Care 11(5) Table 3. Associations of Variables with Abnormal Metabolic Parameters by Logistic Regression Variable OR 95% Confidence Interval Lower Upper P Value ART regimen Zidovudine Stavudine (R) Age a Sex Male Female (R) BMI ART duration a CD a P <.05. Abbreviations: OR, odds ratio; R, reference category. abnormal HDL-cholesterol (40 mg/dl), which was significantly higher in the ART-naive group. There was a significantly higher proportion of patients on d4t regimen with abnormal NCEP III total cholesterol elevation (200 mg/dl; 47.7%) than those on ZDV regimens (24.1%) (P ¼.006). Both groups showed no other significant differences in dyslipidemic patterns. Total duration of ART was positively correlated with total cholesterol (r ¼.197, P ¼.019). Therapy duration also had significant association with dyslipidemia with 47.4% (P ¼ 0.003), 34.2% (P ¼.057), and 48.7% (P ¼.045) of patients developing abnormal elevations of total cholesterol, LDL-cholesterol, and triglycerides more than 2 years after initiating ART. A higher percentage of abnormal reduction in HDL-cholesterol was seen in 39.6% (P ¼.007) of patients within 1 to 2 years of treatment initiation. Type of therapy was not a risk factor for abnormal metabolic parameters by logistic regression analysis but age and duration of ART were risk factors for abnormal metabolic levels (Table 3). Also, abnormal levels of total cholesterol (odds ratio 1.039, 95% CI ,P ¼.008) and triglycerides (odds ratio 1.032, 95% CI , P ¼.024) were independent risk factors with duration of therapy. There was no difference among lipodystrophic and nonlipodystrophic patients with regard to mean BMI and waist-hip ratio (Table 4). However, compared to nonlipodystrophic patients, a higher proportion of lipodystrophic patients were overweight (18.6% vs 13.2 %, P ¼.065). Also, compared to nonlipodystrophic patients, lipoatrophic patients were significantly underweight (25% vs 10.3%; P ¼.022).) Lipodystrophic patients had significantly higher VLDLcholesterol (P ¼.043) and triglycerides (P ¼.043) than nonlipodystrophic patients and also had higher total cholesterol but not significantly (Table 4). Also, lipoatrophic patients had significantly lower waist ( cm vs cm; P ¼.033) and hip circumference ( cm vs cm; P ¼.013) compared to lipohypertrophic patients. Moreover, by logistic regression, only abnormal metabolic levels were a risk factor in lipodystrophy (Table 5). Discussion This is one of the very few studies reporting on the prevalence of lipodystrophy in India. We have demonstrated a high prevalence of lipodystrophy and dyslipidemia among patients taking first-line WHO-recommended regimen in rural South India, as against HIV-infected ART-naive individuals and HIV-negative control group. Majority of the patients were on d4t-based regimen. This regimen is popular because of the fear of development of anemia with AZT-based regimen in a population already having low hemoglobin levels. 7 As per the National ART program, maximum percentage of adults are on the regimen d4t3 þ 3TC þ NVP (42.4%) followed by AZT þ 3TC þ NVP (39.8%). 13 For diagnosing lipodystrophy, we used patient self-reporting and confirmation by a clinician. This is the most widely used method and has been suggested as the best method to use in the absence of objective measures of lipodystrophy. 14,15 This study on the prevalence of lipodystrophy in a rural setting among HIV-infected participants receiving free generic ART from the Indian Government is to our knowledge the first of its kind in India. We documented a higher prevalence of lipodystrophy in our study (60.69%). Higher prevalence of lipodystrophy (46.1%) was documented from a study from Maharashtra, 7 whereas only 14.5% of lipodystrophy was reported in a study from Gujarat, 8 both from western India. Studies have been documented from developed countries with high prevalence of lipodystrophy; similar to the finding of our study. 16,17 We observed that gender may play a role in the prevalence of lipodystrophy in this rural population, with the female gender reporting a higher prevalence. Similar observations were reported from South Africa and Senegal. 18,19 This observation is particularly important when considering the care of HIVinfected women in terms of decisions regarding ART. With respect to the type of regimen, we did not document any significant differences in the prevalence of lipodystrophy between patients currently or previously receiving d4t regimens as opposed to ZDV regimens. This data is contrary to the study in India where d4t use was significantly associated with lipoatrophy. 7 A recent study from the United States reported lipoatrophy to be more frequent with NRTI regimen. 20 However, we did observe a higher but insignificant prevalence of lipoatrophy among all patients receiving d4t regimens as compared to those receiving ZDV regimens only. That we did not observe significant results may be due to the reason that we did not have the past history of d4t usage for 45.5% of our patients. The increased apoptosis of adipocytes may be the possible mechanism for the lipoatrophy associated with d4t. 8 Although we did not note significant results with type of ART regimen, we observed that duration of ART regimen may influence the prevalence of lipodystrophy. This is in concurrence with the studies from Australia and South Africa, which concluded that prevalence and severity of lipodystrophy reflected both length and type of treatment with ART. 21,22 This high prevalence of lipodystrophy is stigmatizing and may lead to poor adherence
5 Kalyanasundaram et al 333 Table 4. Anthropometry and Lipid Profile Values in Lipodystrophy Characteristics Lipodystrophy (n ¼ 88) No Lipodystrophy (n ¼ 57) P Value a Body mass index (kg/m 2 ) Waist hip ratio CD4 count (/ml) b Total cholesterol (mg/dl) HDL-cholesterol (mg/dl) Total-C/HDL-C LDL-cholesterol (mg/dl) VLDL-cholesterol (mg/dl) b Triglycerides (mg/dl) b a t-test. b P <.05. or discontinuation of ART, 16 and may eventually result in treatment failure. Further studies in this population determining the history of ART usage and its relation to lipodystrophy are warranted. With regard to dyslipidemia, according to NCEP III guidelines, we observed that the proportion of patients with abnormal levels of total cholesterol, LDL-cholesterol, and triglycerides were significantly higher in the treatment group when compared to treatment-naive and HIV-negative controls. But we also observed that the prevalence of abnormal HDLcholesterol was lower in the treatment group. The results obtained are similar to that arrived at by Pujari SN et al. 7 Drugs of the NNRTI class, and particularly NVP, although associated with high total cholesterol and LDL-cholesterol levels, may also induce an increase in HDL-cholesterol. 23,24 A predominant percentage (94.4%) of our study population had NVP in their treatment regimen, and the usage of NVP may explain the favorable HDL-C levels in the treatment group compared to the ART-naive group. Although there was a significantly higher proportion of patients on d4t regimen with abnormal NCEP III cholesterol elevation than those on ZDV regimens, type of ART regimen was not a risk factor for dylipidemia by logistic regression. However, duration of ART regimen not only influenced lipodystrophy but also dyslipidemia, even after adjusting for type of therapy, age, sex, and BMI, and was independently associated with NCEP III cholesterol and triglyceride elevation. While a study from India reported no association between dyslipidemia and type and duration of therapy, 7 other studies have documented the effect of NRTI, particularly d4t, in the development of dyslipidemia. 25,26 Moreover, in this study, lipodystrophy was associated with dyslipidemia after adjusting for BMI, age, and sex. Lipodystrophic patients had elevated triglyceride levels compared to nonlipodystrophic patients similar to a study from Senegal. 19 These findings are important as lipid anomalies increase the risk of coronary heart disease. When considering anthropometry, a higher percentage of patients on ART had significantly lower BMI when compared to HIV-negative controls with ART-naive patients being the most underweight. A higher percentage of severely underweight patients of BMI <16.5 kg/m 2 were also seen among Table 5. Associations of Variables with Lipodystrophy by Logistic Regression Variable OR 95% Confidence Interval Lower Upper P Value BMI Sex Age CD Metabolic abnormalties a a P <.05. HIV-infected patients suggesting that nutritional support is needed in the ART centers despite access to HAART. Similar results were seen in the study from Senegal. 19 Limitations of our study include the cross-sectional design and nonrandomized treatment allocations. In addition, morphologic changes were assessed subjectively and did not use Dual Energy Xray Absorptiometry (DEXA) and computed tomography (CT) as they were expensive. In summary, our study demonstrates a high prevalence of morphologic and metabolic complications among patients taking WHO-recommended first-line generic HAART. Female patients presented more with lipodystrophy, particularly with lipoatrophy than males. The type of treatment regimens was not associated with lipodystrophy although d4t usage seemed to affect total cholesterol levels. Total duration of ART was significantly associated with lipodystrophy and dyslipidemia. Presence of lipodystrophy had association with abnormal lipid levels. Also, patients on ART as well as ART-naive patients had lower BMI than HIV-negative patients. This study not only highlights the need for development of inexpensive and accessible treatments for the reduction of lipodystrophy but also the need for adequate nutritional support. Acknowledgments We thank the participants for their valuable time and commitment. We acknowledge the support of Dr E. Ramesh Kumar and the staff of the ART center at Namakkal Head Quarter Hospital. We also thank
6 334 Journal of the International Association of Physicians in AIDS Care 11(5) D. Anitha and A. Ganesh of the Department of Experimental Medicine, The Tamil Nadu Dr MGR Medical University, Chennai, for technical assistance. Our gratitude to the Vice-Chancellor of The Tamil Nadu Dr MGR Medical University for his kind support. Declaration of Conflicting Interests The author(s) declared no conflicts of interest with respect to the authorship and/or publication of this article. Funding The author(s) received no financial support for the research and/or authorship of this article. References 1. Palella FJ, Delaney KM, Moorenman AC. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med. 1998;338(6): Carr A, Samras K, Burton S, et al. A syndrome of peripheral lipodystrophy, hyperlipidaemia, and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998;12(7):F51-F Mondy K, Tebas P. Emerging bone problems in patients infected with human immunodeficiency virus. Clin Infect Dis. 2003; 36(suppl 2):S101-S Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, Cooper DA. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998;12(7):F51-F Duran S, Saves M, Spire B, et al., for the APROCO Study Group. Failure to maintain long term adherence to highly active retroviral therapy: the role of lipodystrophy. AIDS. 2001;15(18): Tien PC, Cole SR, Williams CM, et al. Incidence of lipoatrophy and lipohypertrophy in the womens s interagency HIV study. J Acquir Immune Defic Syndr. 2003;34(5): Sanjay NP, Ameet D, Eknath N, Shobha B, Kaley T, Jeffrey PN, John TS. Lipodystrophy and dyslipidemia among patients taking first-line, World Health Organization Recommended highly active antiretroviral therapy regimens in Western India. J Acquir Immune Defic Syndr. 2005;39(2): Ajay S, Roshni V, Megha M, Archana S, Yogesh M. Adverse effects of antiretroviral treatment. Indian J Dermatol Venereol Leprol. 2008;74(3): Saghayam S, Chaguturu SK, Kumarasamy N, Solomon S, Mayer KH, Wanke C. Lipoatrophy is the predominant presentation of HIV-associated lipodystrophy in southern India. Clin Infect Dis. 2004;38(11): Saghayam S, Kumarasamy N, Cecelia AJ, Solomon S, Mayer K, Wanke C. Weight and body shape changes in a treatment-naive population after 6 months of nevirapine-based generic highly active antiretroviral therapy in South India. Clin Infect Dis. 2007;44(2): Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6): National Cholesterol Education Program (NCEP). Third Report of the National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25): Surveillance, Research/Quarterly CMIS Bulletin April-Sept Bookmark. Pdf. Accessed November 24, Lichtenstein KA, Ward DJ, Moorman AC. Clinical assessment of HIV-associated lipodystrophy in an ambulatory population. AIDS. 2001;15(3): Carr A, Emery S, Law M, et al., on behalf of the HIV Lipodystrophy Case Definition Study Group. An objective case definition of lipodystrophy in HIV-infected adults: a case-control study. Lancet. 2003;361(9359): Bernasconi E, Boubaker K, Junghans C, et al. Swiss HIV Cohort Study. Abnormalities of body fat distribution in HIV-infected persons treated with antiretroviral drugs: the Swiss HIV Cohort Study. J Acquir Immune Defic Syndr. 2002;31(1): Heath KV, Hogg RS, Chan KJ, et al. Lipodystrophy associated morphological, cholesterol and triglyceride abnormalities in population based HIV/AIDS treatment base. AIDS. 2001;15(3): Duran S, Saves M, Spire B, et al., for the APROCO Study Group. Failure to maintain long term adherence to highly active retroviral therapy: the role of lipodystrophy. AIDS. 2001;15(8): Sabine M, Ndeye Fatou Ngom G, Amandine C, et al. Lipodystrophy and metabolic disorders in HIV-1 infected adults on 4- to 9-year antiretroviral therapy in senegal: a case control study. J Acquir Immune Defic Syndr. 2009;51(2): Haubrich RH, Riddler SA, DiRienzo AG, et al. Metabolic outcomes in a randomized trial of nucleoside, nonnucleoside and protease inhibitor sparing regimens for initial HIV treatment. AIDS. 2009;23(9): Miller J, Carr A, Emery S, et al. HIV lipodystrophy: prevalence, severity and correlates of risk in Australia. HIV Med. 2003;4(3): Mutimura E, Stewart A, Rheeder P, Crowther NJ. Metabolic function and the prevalence of lipodystrophy in a population of HIV-infected African subjects receiving highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2007;46(4): Fontas E, Van Leth F, Sabin A, et al. Lipid profiles in HIVinfected patients receiving combination antiretroviral therapy: are different antiretroviral drugs associated with different lipid profiles? J Infect Dis. 2004;189(6): van der Valk M, Kastelein JJ, Murphy RL, et al. Nevirapinecontaining antiretroviral therapy in HIV-1 infected patients results in an antiatherogenic lipid profile. AIDS. 2001;15(18): Galli M, Ridolfo AL, Adorni F, et al. Body habitus changes and metabolic alterations in protease inhibitor-naive HIV-1-infected patients treated with two nucleoside reverse transcriptase inhibitors. J Acquir Immune Defic Syndr. 2002;29(1): Gallant JE, Staszewski S, Pozniak A, et al. Efficacy and safety of tenofovir DF vs stavudine in combination therapy in antiretroviral-naive patients: a 3 year randomized trial. JAMA. 2004;292(2):
Leptin levels and menstrual function in HIV-infected women in rural India
Leptin levels and menstrual function in HIV-infected women in rural India Annie Phoebe. K¹, Mini Jacob.S¹, Hemalatha.R², Sivakumar M.R¹ ¹Department of Experimental Medicine, The Tamil Nadu Dr. MGR Medical
More informationTOXICITY, TOLERABILITY, AND ADHERENCE TO THERAPY
SAFETY AND TOLERABILITY OF CURRENTLY AVAILABLE ANTIRETROVIRAL AGENTS * Esteban Martinez, MD, PhD ABSTRACT Safety and tolerability are important factors to consider when instituting or modifying therapy
More informationHighly active antiretroviral therapy (HAART) has dramatically
HIV Re p o r t s Recovery From Lipodystrophy in HIV infected Children After Substitution of Stavudine With Zidovudine in a n-nucleoside Reverse Transcriptase Inhibitor based Antiretroviral Therapy Linda
More informationDidactic Series. Lipohypertrophy in HIV
Didactic Series Lipohypertrophy in HIV Daniel Lee, MD Clinical Professor of Medicine UCSD Medical Center Owen Clinic August 14th, 2014 ACCREDITATION STATEMENT: University of California, San Diego School
More informationPrevalence of Comorbidities among HIV-positive patients in Taiwan
Prevalence of Comorbidities among HIV-positive patients in Taiwan Chien-Ching Hung, MD, PhD Department of Internal Medicine National Taiwan University Hospital, Taipei, Taiwan % of participants Comorbidity
More informationPlasma fibrinogen level, BMI and lipid profile in type 2 diabetes mellitus with hypertension
World Journal of Pharmaceutical Sciences ISSN (Print): 2321-3310; ISSN (Online): 2321-3086 Published by Atom and Cell Publishers All Rights Reserved Available online at: http://www.wjpsonline.org/ Original
More informationColleen Hadigan, 1 Shafali Jeste, 1 Ellen J. Anderson, 2 Rita Tsay, 3 Helen Cyr, 3 and Steven Grinspoon 1. Kenneth H. Mayer, Section Editor
HIV/AIDS Kenneth H. Mayer, Section Editor MAJOR ARTICLE Modifiable Dietary Habits and Their Relation to Metabolic Abnormalities in Men and Women with Human Immunodeficiency Virus Infection and Fat Redistribution
More informationFat redistribution on ARVs: dogma versus data
Fat redistribution on ARVs: dogma versus data Gary Maartens Division of Clinical Pharmacology UNIVERSITY OF CAPE TOWN IYUNIVESITHI YASEKAPA UNIVERSITEIT VAN KAAPSTAD Half of what we are going to teach
More informationCHAPTER IV RESEARCH METHOD. This study belongs to the field of Internal Medicine, specifically the field
CHAPTER IV RESEARCH METHOD 4.1 Research fields This study belongs to the field of Internal Medicine, specifically the field of Infectious and Tropical Disease. 4.2 Research location and period This study
More informationThe Lipid-Lowering Efficacy of Switching Within Non-Nucleoside Reverse Transcriptase Inhibitors in HIV-Infected Patients
American Journal of Infectious Diseases 4 (2): 147-151, 2008 ISSN 1553-6203 2008 Science Publications The Lipid-Lowering Efficacy of Switching Within Non-Nucleoside Reverse Transcriptase Inhibitors in
More informationCHAPTER 3 DIABETES MELLITUS, OBESITY, HYPERTENSION AND DYSLIPIDEMIA IN ADULT CENTRAL KERALA POPULATION
CHAPTER 3 DIABETES MELLITUS, OBESITY, HYPERTENSION AND DYSLIPIDEMIA IN ADULT CENTRAL KERALA POPULATION 3.1 BACKGROUND Diabetes mellitus (DM) and impaired glucose tolerance (IGT) have reached epidemic proportions
More informationAssociate Professor, Department of General Medicine, Mysore Medical College and Research Institute, Mysuru, Karnataka, India, 2
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/286 Correlation between High-density Lipoprotein Cholesterol Level and CD4 Cell Count in HIV Patients on NNRTI-based
More informationWhen to Rock the Boat Switching Antiretroviral Therapy for Metabolic Complications
When to Rock the Boat Switching Antiretroviral Therapy for Metabolic Complications 12 th Annual Tennessee AETC/CCC HIV Symposium 6 November 2009 Todd Hulgan, MD, MPH Assistant Professor of Medicine Division
More informationHIV Infection as a Chronic Disease. Howard Libman, MD Beth Israel Deaconess Medical Center Harvard Medical School
HIV Infection as a Chronic Disease Howard Libman, MD Beth Israel Deaconess Medical Center Harvard Medical School Role of Primary Care Approximately 50,000 patients are diagnosed with HIV infection annually
More informationA study of waist hip ratio in identifying cardiovascular risk factors at Government Dharmapuri College Hospital
Original Research Article A study of waist hip ratio in identifying cardiovascular risk factors at Government Dharmapuri College Hospital M. Arivumani * Assistant Professor of General Medicine, Government
More informationHIV Treatment Update. Awewura Kwara, MD, MPH&TM Associate Professor of Medicine and Infectious Diseases Brown University
HIV Treatment Update Awewura Kwara, MD, MPH&TM Associate Professor of Medicine and Infectious Diseases Brown University Outline Rationale for highly active antiretroviral therapy (HAART) When to start
More informationIschemic Cardiovascular Disease in Persons with Human Immunodeficiency Virus Infection
HIV/AIDS MAJOR ARTICLE Ischemic Cardiovascular Disease in Persons with Human Immunodeficiency Virus Infection Max H. David, 1,3 Richard Hornung, 2 and Carl J. Fichtenbaum 1 1 Department of Medicine, Division
More informationCLINICAL: ADULT. published in the peer-reviewed literature.
CLINICAL: ADULT CHANGES IN BODY COMPOSITION AND OTHER ANTHROPOMETRIC MEASURES OF FEMALE SUBJECTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART): A PILOT STUDY IN KWAZULU-NATAL, SOUTH AFRICA F M Esposito1,2,
More informationTo interrupt or not to interrupt Are we SMART enough?
SMART To interrupt or not to interrupt Are we SMART enough? highly active antiretroviral therapy 5 1996 1997 10 25 43 45 35 metabolism 50 copies/ml lipodystrophy [fat redistribution syndrome] lactic acidosis
More informationTitle: Do non-nucleoside reverse transcriptase inhibitors contribute to lipodystrophy?
Title: Do non-nucleoside reverse transcriptase inhibitors contribute to lipodystrophy? Author(s): David Nolan Source: Drug Safety. 28.12 (Dec. 2005): p1069. Document Type: Article Full Text: COPYRIGHT
More informationJournal of the International AIDS Society
Journal of the International AIDS Society Research article Effectiveness and Safety of Generic Fixed-Dose Combination of Tenofovir/Emtricitabine/Efavirenz in HIV-1-Infected Patients in Western India Sanjay
More informationResearch Article Metabolic Disorders in HIV-Infected Adolescents Receiving Protease Inhibitors
Hindawi BioMed Research International Volume 2017, Article ID 7481597, 14 pages https://doi.org/10.1155/2017/7481597 Research Article Metabolic Disorders in HIV-Infected Adolescents Receiving Protease
More informationWhat is Malnutrition?
HIV & Obesity Gail Shor-Posner, PhD Director, Division of Disease Prevention Department of Epidemiology & Public Health University of Miami Miller School of Medicine What is Malnutrition? Under-nutrition
More informationHigher Risk of Hyperglycemia in HIV-Infected Patients Treated with Didanosine Plus Tenofovir
6131_06_p333-337 4/5/06 10:28 AM Page 333 AIDS RESEARCH AND HUMAN RETROVIRUSES Volume 22, Number 4, 2006, pp. 333 337 Mary Ann Liebert, Inc. Higher Risk of Hyperglycemia in HIV-Infected Patients Treated
More informationMonitoring of lipodystrophic and metabolic abnormalities in HIV-1 infected children on antiretroviral therapy
HORMONES 2011, 10(2):149-155 Research paper Monitoring of lipodystrophic and metabolic abnormalities in HIV-1 infected children on antiretroviral therapy Vana Spoulou, 1 Christina Kanaka-Gantenbein, 1
More informationGender Differences in clinical and immunological outcomes in South African HIV-infected patients on HAART
RESEARCH REPORT TITLE Gender Differences in clinical and immunological outcomes in South African HIV-infected patients on HAART Submitted for the degree: MSc (MED) EPIDEMIOLOGY AND BIOSTATISTICS School
More informationInt. J. Pharm. Sci. Rev. Res., 26(2), May Jun 2014; Article No. 15, Pages: 79-83
Research Article Comparing Efficacy and Safety of Stavudine Plus Lamivudine Versus Zidovudine Plus Lamivudine in Combination with Nevirapine in HIV Infected Individuals Receiving Antiretroviral Therapy
More informationLipoatrophy and Fat Accumulation in HIV-Infected Adults
Switch to a PI-Containing/NRTI-Sparing regimen (LPVr/EFV) increases appendicular fat content and serum lipid levels without affecting glucose metabolism or bone mineral density. The results of a prospective
More informationThe role of efavirenz compared with protease inhibitors in the body fat changes associated with highly active antiretroviral therapy
Journal of Antimicrobial Chemotherapy (2008) 62, 234 245 doi:10.1093/jac/dkn191 Advance Access publication 14 May 2008 The role of efavirenz compared with protease inhibitors in the body fat changes associated
More informationWeight evolution and perceptions of adults living with HIV following initiation of antiretroviral therapy in a South African urban setting
Weight evolution and perceptions of adults living with HIV following initiation of antiretroviral therapy in a South African urban setting E Hurley, A Coutsoudis, J Giddy, S E Knight, E Loots, T M Esterhuizen
More informationKirsten A. Walker. Submitted in partial fulfilment of the requirements for the degree of Master of Science
THE ASSOCIATION OF TRADITIONAL, NONTRADITIONAL, HIV, AND HIGHLY ACTIVE ANTIRETROVIRAL THERAPY RELATED RISK FACTORS AND DYSLIPIDEMIA AMONG PEOPLE WHO ARE LIVING WITH HIV IN NOVA SCOTIA: A LONGITUDINAL COHORT
More informationA Genetic Test to Screen for Abacavir Hypersensitivity Reactions
The Future of Pharmacogenetics in HIV Clinical Care A Genetic Test to Screen for Abacavir Hypersensitivity Reactions Evan Collins & Misty Bath CANAC/ACIIS 15 th Annual Conference Vancouver, BC April 2007
More informationPAEDIATRIC HIV INFECTION. Dr Ashendri Pillay Paediatric Infectious Diseases Specialist
PAEDIATRIC HIV INFECTION Dr Ashendri Pillay Paediatric Infectious Diseases Specialist Paediatric HIV Infection Epidemiology Immuno-pathogenesis Antiretroviral therapy Transmission Diagnostics Clinical
More informationEFFECT OF SMOKING ON BODY MASS INDEX: A COMMUNITY-BASED STUDY
ORIGINAL ARTICLE. EFFECT OF SMOKING ON BODY MASS INDEX: A COMMUNITY-BASED STUDY Pragti Chhabra 1, Sunil K Chhabra 2 1 Professor, Department of Community Medicine, University College of Medical Sciences,
More informationAnumber of clinical trials have demonstrated
IMPROVING THE UTILITY OF PHENOTYPE RESISTANCE ASSAYS: NEW CUT-POINTS AND INTERPRETATION * Richard Haubrich, MD ABSTRACT The interpretation of a phenotype assay is determined by the cut-point, which defines
More informationAntiretroviral treatment outcomes after the introduction of tenofovir in the public-sector in South Africa
Antiretroviral treatment outcomes after the introduction of tenofovir in the public-sector in South Africa Alana T Brennan, Kate Shearer, Mhairi Maskew, Prudence Ive, Ian Sanne, Matthew P Fox Health Economics
More informationJournal of the American College of Cardiology Vol. 48, No. 2, by the American College of Cardiology Foundation ISSN /06/$32.
Journal of the American College of Cardiology Vol. 48, No. 2, 2006 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.03.043
More informationElevated Serum Levels of Adropin in Patients with Type 2 Diabetes Mellitus and its Association with
Elevated Serum Levels of Adropin in Patients with Type 2 Diabetes Mellitus and its Association with Insulin Resistance Mehrnoosh Shanaki, Ph.D. Assistant Professor of Clinical Biochemistry Shahid Beheshti
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Study on Prevalence of Pre-Diabetes in Urban Area of Mumbai and Its Association with Various
More informationAbdominal volume index and conicity index in predicting metabolic abnormalities in young women of different socioeconomic class
Research Article Abdominal volume index and conicity index in predicting metabolic abnormalities in young women of different socioeconomic class Vikram Gowda, Kripa Mariyam Philip Department of Physiology,
More informationProcedures for taking physical measurements
Procedures for taking physical measurements Dr Diane Cooper PhD Exercise physiology and metabolism Partner in True Fitness Coordinator & lecturer on BSc Sports Science, AIT Metabolic researcher on European
More information0.14 ( 0.053%) UNAIDS 10% (94) ( ) (73-94/6 ) 8,920
0.14 UNAIDS 0.053% 2 250 60 10% 94 73 20 73-94/6 8,920 12 43 Public Health Service Task Force Recommendations 5-10% for Use of Antiretroviral Drugs in 10-20% Pregnant HIV-1-Infected Women for Maternal
More informationFigure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution
Figure S1. Comparison of fasting plasma lipoprotein levels between males (n=108) and females (n=130). Box plots represent the quartiles distribution of A: total cholesterol (TC); B: low-density lipoprotein
More informationNOTICE TO PHYSICIANS. Division of AIDS (DAIDS), National Institute of Allergy and Infectious Diseases, National Institutes of Health
NOTICE TO PHYSICIANS DATE: March 10, 2003 TO: FROM: SUBJECT: HIV/AIDS Health Care Providers Division of AIDS (DAIDS), National Institute of Allergy and Infectious Diseases, National Institutes of Health
More informationSupplemental Digital Content 1. Combination antiretroviral therapy regimens utilized in each study
Supplemental Digital Content 1. Combination antiretroviral therapy regimens utilized in each study Study Almeida 2011 Auld 2011 Bassett 2012 Bastard 2012 Boulle 2008 (a) Boulle 2008 (b) Boulle 2010 Breen
More informationDYSLIPIDAEMIC PATTERN OF PATIENTS WITH TYPE 2 DIABETES MELLITUS. Eid Mohamed, Mafauzy Mohamed*, Faridah Abdul Rashid
Malaysian Journal of Medical Sciences, Vol. 11, No. 1, January 2004 (44-51) ORIGINAL ARTICLE DYSLIPIDAEMIC PATTERN OF PATIENTS WITH TYPE 2 DIABETES MELLITUS Eid Mohamed, Mafauzy Mohamed*, Faridah Abdul
More informationReasons for Anti-Retroviral Regimen Changes in HIV/AIDS patients of Ayder Referral Hospital ART clinic, Mekelle, Ethiopia.
Reasons for Anti-Retroviral Regimen Changes in HIV/AIDS patients of Ayder Referral Hospital ART clinic, Mekelle, Ethiopia. LEMLEM GEBREMEDHIN *, AMANUEL BIRHANE 2, 2 Pharmacology and Toxicology course
More informationCorrelation between fasting insulin and blood pressure in obese and non-obese middle aged Indian diabetic adults
Volume: 2, Issue: 5, 241-245 May 2015 www.allsubjectjournal.com e-issn: 2349-4182 p-issn: 2349-5979 Impact Factor: 3.762 Raja Reddy P Assistant professor, Department of Physiology, Sri Devaraj Urs Medical
More informationA Descriptive Study of Outcomes of Interventions to Prevent Mother to Child Transmission of HIV in Lusaka, Zambia
ORIGINAL PAPER A Descriptive Study of Outcomes of Interventions to Prevent Mother to Child Transmission of HIV in Lusaka, Zambia Chibesa Shichitamba W, National Malaria Control Centre, Lusaka-Zambia ABSTRACT
More informationPrinciples of Antiretroviral Therapy
Principles of Antiretroviral Therapy Ten Principles of Antiretroviral Therapy Skills Building Workshop: Clinical Management of HIV Infection and Antiretroviral Therapy, 11 th ICAAP, November 21st, 2011,
More informationClinical Management Guidelines 2012
Central American Course Monitoring and Evaluation for HIV/AIDS Policy and Program Management 1 2 3 4 Module 1 Unit 1 Clinical Management Guidelines 2012 National TB, HIV/AIDS & other STIs Programme Ministry
More informationTHE BURDEN OF METABOLIC DISEASES AMONGST HIV POSITIVE PATIENTS ON HAART ATTENDING
THE BURDEN OF METABOLIC DISEASES AMONGST HIV POSITIVE PATIENTS ON HAART ATTENDING THE JOHANNESBURG HOSPITAL Henry P Julius Research report submitted to the Faculty of Health Science, University of the
More informationIntroduction: WHO recommends that criteria for starting ART be defined in national protocols and that these
ISSN: 0975-766X Available Online through Research Article www.ijptonline.com HEALTH PROFILE OF HIV POSITIVE INDIVIDUALS AT ANTI RETROVIRAL TREATMENT CENTRE, KADAPA DISTRICT Dr.K.Chandra Sekhar *, Dr. K.J.Kishore
More informationBody Mass Index and Waist Hip Ratio among Youth of India
Body Mass Index and Waist Hip Ratio among Youth of India 1 Dr. Anju Pathak and 2 Prof. A. K. Datta 1 Assistant Professor Dept. of Physical Education- TEL&R, PGGC, Sector-11, Chandigarh 2 Ex-Head, Department
More informationJean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, 2 Tufts New England Medical Center, 3
HIV/AIDS MAJOR ARTICLE CD4 + Cell Count, Viral Load, and Highly Active Antiretroviral Therapy Use Are Independent Predictors of Body Composition Alterations in HIV-Infected Adults: A Longitudinal Study
More informationMetabolic Abnormalities and Cardiovascular Disease Risk Factors in Adults with Human Immunodeficiency Virus Infection and Lipodystrophy
HIV/AIDS MAJOR ARTICLE Metabolic Abnormalities and Cardiovascular Disease Risk Factors in Adults with Human Immunodeficiency Virus Infection and Lipodystrophy Colleen Hadigan, 1,4 James B. Meigs, 3 Colleen
More informationAnemia among HIV-infected Individuals in South India
Yale University EliScholar A Digital Platform for Scholarly Publishing at Yale Yale Medicine Thesis Digital Library School of Medicine 2007 Anemia among HIV-infected Individuals in South India Ramnath
More informationChanges in Lipid Profiles and Other Biochemical Parameters in HIV-1 Infected Patients Newly Commenced on HAART Regimen
Infectious Disease: Research and Treatment Original Research Open Access Full open access to this and thousands of other papers at http://www.la-press.com. Changes in Lipid Profiles and Other Biochemical
More informationHIGH-DENSITY LIPOPROTEIN (HDL) is one of
Psychiatry and Clinical Neurosciences 2010; 64: 279 283 doi:10.1111/j.1440-1819.2010.02079.x Regular Article Low serum HDL-cholesterol levels are associated with long symptom duration in patients with
More informationMetabolic Effects Associated to the Highly Active Antiretroviral Therapy (HAART) in AIDS Patients
13 BJID 29; 13 (April) Metabolic Effects Associated to the Highly Active Antiretroviral Therapy (HAART) in AIDS Patients Hamilton Domingos 1, Rivaldo Venâncio da Cunha 1, Anamaria Mello Miranda Paniago
More informationSupplemental Table S2: Subgroup analysis for IL-6 with BMI in 3 groups
Supplemental Table S1: Unadjusted and Adjusted Hazard Ratios for Diabetes Associated with Baseline Factors Considered in Model 3 SMART Participants Only Unadjusted Adjusted* Baseline p-value p-value Covariate
More informationD:A:D Study Teaching Material
D:A:D Study Teaching Material Data Collection of Adverse events of anti-hiv Drugs (D:A:D) study December 2012 - CHIP Background The D:A:D Study, is a prospective cohort study (collaboration) initiated
More informationA comparative study on the fasting and post prandial lipid levels as a cardiovascular risk factor in patients with type 2 diabetes mellitus
Original Research Article A comparative study on the fasting and post prandial lipid levels as a cardiovascular risk factor in patients with type 2 diabetes mellitus Deepa Kalikavil Puthenveedu 1, Sundaraj
More informationLipid Profile, Cardiovascular Risk Factors and Metabolic Syndrome in a Group of AIDS Patients
Lipid Profile, Cardiovascular Risk Factors and Metabolic Syndrome in a Group of AIDS Patients Érika Ferrari Rafael da Silva 1, Katia Cristina Bassichetto 2, David Salomão Lewi 1 Universidade Federal de
More informationIMPROVEMENT in LIPOATROPHY ASSOCIATED with HIGHLY ACTIVE ANTIRETROVIRAL THERAPY in HIV-INFECTED CHILDREN SWITCHED from STAVUDINE to TENOFOVIR
Poster R-105 IMPROVEMENT in LIPOATROPHY ASSOCIATED with HIGHLY ACTIVE ANTIRETROVIRAL THERAPY in HIV-INFECTED CHILDREN SWITCHED from STAVUDINE to TENOFOVIR ALESSANDRA VIGANO 1, PAOLO BRAMBILLA 1, LAURA
More informationThe effects of Aerobic Exercise vs. Progressive Resisted Exercise on body composition in obese children Dr.U.Ganapathy Sankar, Ph.
The effects of Aerobic Exercise vs. Progressive Resisted Exercise on body composition in obese children Dr.U.Ganapathy Sankar, Ph.D Dean I/C, SRM College of Occupational Therapy, SRMUniversity, Kattankulathur,
More informationStructured Treatment Interruption in HIV Positive Patients. Leah Jackson, BScPhm Pharmacy Resident HIV Rotation January 23, 2007
Structured Treatment Interruption in HIV Positive Patients Leah Jackson, BScPhm Pharmacy Resident HIV Rotation January 23, 2007 Objectives To become re-acquainted with the basics of HAART for HIV infection
More informationNURSING CARE. HIV-Infected INMATE. of the. METABOLIC COMPLICATIONS of HIV. Albany Medical Center. Module 9 S U M M E R / F A L L
NURSING CARE of the HIV-Infected INMATE METABOLIC COMPLICATIONS of HIV Module 9 S U M M E R / F A L L 0 0 7 Albany Medical Center This learning activity is co-provided by The Albany Medical Center Hospital
More informationFriedewald formula. ATP Adult Treatment Panel III L D L Friedewald formula L D L = T- C H O - H D L - T G / 5. Friedewald formula. Friedewald formula
Friedewald formula 1 1 1,2 ATP Adult Treatment Panel III L D L Friedewald formula L D L = T- C H O - H D L - T G / 5 Friedewald formula Friedewald formula 2003 99 Friedewald formula Colorimetric method
More informationHans Strijdom SA Heart Meeting November 2017
Hans Strijdom SA Heart Meeting November 2017 HIV-infection and ART, but not high sensitivity CRP, are associated with markers of vascular function: Results from the Western Cape cohort of the EndoAfrica
More informationTHE SOUTH AFRICAN ANTIRETROVIRAL TREATMENT GUIDELINES 2010
THE SOUTH AFRICAN ANTIRETROVIRAL TREATMENT GUIDELINES 2010 The South African Antiretroviral Treatment Guidelines 2010 Goals of the programme Achieve best health outcomes in the most cost-efficient manner
More informationefigure 1: Process of identification and selection of studies for inclusion in the review
efigure 1: Process of identification and selection of studies for inclusion in the review 1 efigure 2: Publication bias in studies reporting incidence rate of diabetes mellitus in ART-experienced global
More informationVitamin D Deficiency in HIV: A Shadow on Long-Term Management?
AIDS Rev. 2014;16:59-74 (Supplementary Data) Vitamin D Deficiency in HIV: A Shadow on Long-Term Management? Chloe Orkin, et al.: Vitamin D deficiency in HIV (Supplementary Data) Chloe Orkin 1, David A.
More information1. Africa Centre for Health and Population Studies 2. London School of Hygiene and Tropical Medicine 3. University College London
A systematic review of the effects of interrupted antiretroviral interventions for prevention of mother-to-child transmission of HIV on maternal disease progression and survival Naidu KK 1, Mori R 2, Newell
More informationTHE EFFECT OF VITAMIN-C THERAPY ON HYPERGLYCEMIA, HYPERLIPIDEMIA AND NON HIGH DENSITY LIPOPROTEIN LEVEL IN TYPE 2 DIABETES
Int. J. LifeSc. Bt & Pharm. Res. 2013 Varikasuvu Seshadri Reddy et al., 2013 Review Article ISSN 2250-3137 www.ijlbpr.com Vol. 2, No. 1, January 2013 2013 IJLBPR. All Rights Reserved THE EFFECT OF VITAMIN-C
More informationd4t (stavudine, Zerit)
d4t (stavudine, Zerit) Summary d4t (stavudine, Zerit) is a type of anti-hiv drug called a nuke or nucleoside analogue. Common side effects of d4t can include headache, nausea, vomiting and diarrhea. d4t
More informationANTIRETROVIRAL TOXICITY Strategies for prevention and treatment
ANTIRETROVIRAL TOXICITY Strategies for prevention and treatment Francisco Antunes Professor da Faculdade de Medicina da Universidade de Lisboa e Director do Serviço de Doenças Infecciosas do Hospital de
More informationOsteopenia in HIV-infected men: association with asymptomatic lactic acidemia and lower weight pre-antiretroviral therapy
Osteopenia in HIV-infected men: association with asymptomatic lactic acidemia and lower weight pre-antiretroviral therapy Andrew Carr a, John Miller b, John A. Eisman c and David A. Cooper a,b Background:
More informationPerspectives Management of Dyslipidemia and Other Cardiovascular Risk Factors in HIV-Infected Patients: Case-based Review
International AIDS Society USA Topics in HIV Medicine Perspectives Management of Dyslipidemia and Other Cardiovascular Risk Factors in HIV-Infected Patients: Case-based Review Many HIV-infected patients
More information3TC (lamivudine, Epivir)
FACTSHEET 3TC (lamivudine, Epivir) Summary 3TC is a type of antiretroviral drug called a nucleoside analogue (or nuke ). 3TC can cause nausea, headache, diarrhea, vomiting and weakness; however, it causes
More informationSwitching Effective Antiretroviral Therapy: A Review
INVITED ARTICLE HIV/AIDS Kenneth H. Mayer, Section Editor Switching Effective Antiretroviral Therapy: A Review Henning Drechsler and William G. Powderly Division of Infectious Diseases, Washington University
More informationTo put lipid-related complications seen in
MANAGING REGIMEN DIFFICULTIES: MEETING THE CHALLENGES OF SAFETY AND TOLERABILITY * Simon A. Mallal, MBBS, FRACP, FRCPA ABSTRACT HIV-infected patients who are naive to antiretroviral therapy usually demonstrate
More informationHIV and Co-morbidities November 18, 2013, 3:10 pm Abstract Number 141
Low omega-3 index in erythrocytes is a risk factor for progression of atherosclerosis in people living with HIV Bianca M Arendt, M Smieja, IE Salit, DWL Ma, F Smaill, D Elston, E Lonn, Johane P Allard
More informationTDF containing ART: Efficacy and Safety. Dr Lloyd B. Mulenga Adult Infectious Diseases Centre University Teaching Hospital Lusaka, Zambia
TDF containing ART: Efficacy and Safety Dr Lloyd B. Mulenga Adult Infectious Diseases Centre University Teaching Hospital Lusaka, Zambia 1 Indications Treatment of HIV-1 in combination with other antiretroviral
More informationEvolving Realities of HIV Treatment in Resource-limited Settings
Evolving Realities of HIV Treatment in Resource-limited Settings Papa Salif Sow MD, MSc Department of Infectious Diseases University of Dakar, Senegal Introduction: ARV access in RLS Scale-up of ART has
More informationFixed Dose Combination a Simplified Approach to Pediatric Antiretroviral Treatment
Fixed Dose Combination a Simplified Approach to Pediatric Antiretroviral Treatment Dr. David Pugatch Clinton Foundation Phnom Penh, Cambodia February, 2007 Lecture Goals To introduce and define fixed dose
More informationAdult BMI Calculator
For more information go to Center for Disease Control http://search.cdc.gov/search?query=bmi+adult&utf8=%e2%9c%93&affiliate=cdc-main\ About BMI for Adults Adult BMI Calculator On this page: What is BMI?
More informationWHO MODEL LIST OF ESSENTIAL MEDICINES APPLICATION. stavudine/lamivudine/nevirapine fixed-dose combination tablets for the treatment of HIV-1 infection
WHO MODEL LIST OF ESSENTIAL MEDICINES APPLICATION stavudine/lamivudine/nevirapine fixed-dose combination tablets for the treatment of HIV-1 infection 1. Summary statement of proposal for inclusion, change,
More informationSUMMARY OF STUDY STUDY SUBJECTS CONDUCT OF THE STUDY INTRODUCTION OBJECTIVES
SUMMARY OF STUDY INTRODUCTION Coronary heart disease and stroke have contributed significantly to the mortality of both men and women in the developed and developing world. High-density cholesterol-lipoprotein
More informationTable S1. Characteristics associated with frequency of nut consumption (full entire sample; Nn=4,416).
Table S1. Characteristics associated with frequency of nut (full entire sample; Nn=4,416). Daily nut Nn= 212 Weekly nut Nn= 487 Monthly nut Nn= 1,276 Infrequent or never nut Nn= 2,441 Sex; n (%) men 52
More informationDifferent worlds, different tasks for health promotion: comparisons of health risk profiles in Chinese and Finnish rural people
HEALTH PROMOTION INTERNATIONAL Vol. 16, No. 4 Oxford University Press 2001. All rights reserved Printed in Great Britain Different worlds, different tasks for health promotion: comparisons of health risk
More informationIJBCP International Journal of Basic & Clinical Pharmacology
Print ISSN: 2319-2003 Online ISSN: 2279-0780 IJBCP International Journal of Basic & Clinical Pharmacology DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20172719 Original Research Article Prevalence of
More informationPatients with persistently low CD4 counts on antiretroviral
Predicting HIV Care Costs Using CD4 Counts From Clinical Trials Andrew Hill, PhD; and Kelly Gebo, MD, MPH Objective: To predict the effects of a new antiretroviral agent on the costs of care in a US HIV
More informationWIHS Metabolic Working Group Summary
Metabolics Prepared by: Phyllis Tien on behalf of the Metabolic Working Group WIHS Metabolic Working Group Summary Aims of the Metabolic Working Group: To examine the role of chronic inflammation, coinfections,
More informationFactors Associated with Metabolic Syndrome among HIV-positive Patients at a Health Facility in Botswana
British Journal of Medicine & Medical Research 4(12): 2352-2361, 2014 SCIENCEDOMAIN international www.sciencedomain.org Factors Associated with Metabolic Syndrome among HIV-positive Patients at a Health
More informationPrevention of Mother to Child Transmission of HIV: Our Experience in South India
pg 62-66 Original Article Prevention of Mother to Child Transmission of HIV: Our Experience in South India Karthekeyani Vijaya 1, Alexander Glory 2, Solomon Eileen 3, Rao Sarita 4, Rao P.S.S.Sunder 5 1
More informationInternational Journal of Pharma and Bio Sciences V1(2)2010 A STUDY ON PRESCRIPTION PATTERN AND COST ANALYSIS OF ANTIRETROVIRAL DRUGS.
SANKAR VEINTRAMUTHU 1 *, RUCKMANI KANDASAMY 2, VELAYUTHAM KANNIYAPPAN 1, NITHYANANTH MUNUSAMY 1 1 Department of Pharmaceutics, PSG College of Pharmacy, Coimbatore- 641004. 2 Department of Pharmaceutical
More informationKeywords: Type 2 DM, lipid profile, metformin, glimepiride ABSTRACT
Human Journals Research Article September 2015 Vol.:4, Issue:2 All rights are reserved by K. Saravanan et al. Effects of Monotherapy and Combination Therapy Involving Metformin and Glimepiride on HbA1c
More informationAssessment of the therapeutic success of antiretroviral combinations used in a HIV treatment center, Jos, Nigeria
World Journal of Pharmaceutical Sciences ISSN (Print): 3-330; ISSN (Online): 3-3086 Published by Atom and Cell Publishers All Rights Reserved Available online at: http://www.wjpsonline.org/ Original Article
More informationRole of Efavirenz in HIV-infected Patients with Preceding Nevirapine-related Skin Rash
Review Article Vol. 24 No. 2 Nevirapine-associated rashes:- Manosuthi W & Sungkanuparph S. 89 Role of Efavirenz in HIV-infected Patients with Preceding Nevirapine-related Skin Rash Weerawat Manosuthi,
More information