Table 1.
Low-income countries
| Region | Population | N | Study objective | Lipodystrophy, lipoatrophy, lipohypertrophy | Other findings |
|---|---|---|---|---|---|
| AFRICA | |||||
| Prospective cohort | |||||
| Benin [33] | HIV+ initiating HAART | 79 | LD incidence and risk factors of NNRTIs | LD: 30% (11 mo) Mixed: 2.5%, LH: 24%, LA: 9% |
Significant weight gain on ART, 13% developed metabolic syndrome |
| Uganda [107] | HIV+ initiating HAART | 76 | Anthropometry, total fat, lean mass with AZT | HIV+: increased lean and fat mass; arm, waist, hip and thigh circumferences; and abdomen, subscapular, thigh SFT at 6 mo vs. controls | |
| Cross-sectional | |||||
| Ethiopia [154] | HIV+ on HAART >1 y | 356 | Prevalence and risk factors of LD | LD: 68.3% | LA/LH risk factors: smoking, d4T, >1 y ART |
| Ethiopia [152] | HIV+ on HAART | 313 | Prevalence of BFR and metabolic changes | LD: 12.1% | LD risk factors: ART >12 mo |
| Malawi [165] | HIV+ on d4T for ≥6 mo | 203 | d4T toxicity and mtDNA/nDNA ratio | LD: 18% (25 mo) | No association between LD and mtDNA/nuclear DNA ratio |
| ASIA | |||||
| Cross-sectional | |||||
| Cambodia [44] | HIV+ initiating ART | 467 | Immunovirological ART outcomes, adverse events | LD: 63% (4 y) | d4T adverse events: BFR, dyslipidemia, increased liver enzymes, peripheral neuropathy |
| Cambodia [166] | HIV+ on ART ≥2 y | 346 | Prevalence and predictors of non-adherence | Independent predictors of non-adherence: LD- related side-effects, rural residence, HIV disclosure to <2 family members | |
| Retrospective | |||||
| Cambodia [32] | HIV+ initiating d4T | 2481 | Long term toxicity (6 y) with d4T | LA: 0.8% (6 mo), 7% (1 y), 56.1% (3 y), 72.4% (6 y) | d4T Regimen change: 37.1% due to LD Risk Factors: age >40 y, female, CD4 <200 cells/μL |
WHO GDP $1,025 or less. ABC: abacavir; ART: antiretroviral therapy; AZT: zidovudine; BFR: body fat redistribution; d4T: stavudine HAART: highly active antiretroviral therapy; HIV: human immunodeficiency virus; LA: lipoatrophy; LD: lipodystrophy; LH: lipohypertrophy; mo: months; SFT: skinfold thickness; TC: total cholesterol; TG: triglycerides; WC: waist circumference; WHR: waist to height ratio; y: years. Prevalence unless otherwise noted.