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Sacilotto LB, Papini SJ, Mendes AL, Gatto M, Pereira PCM, Corrente JE, da Silva JDF. Relationship Between Lipodystrophy, Body Composition, Metabolic Profile, and Serum Levels of Adipocytokines. Front Nutr 2021; 8:750721. [PMID: 34957175 PMCID: PMC8698133 DOI: 10.3389/fnut.2021.750721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Despite the benefits in improving the clinical state of people living with HIV/aids (PLWHA), some side effects associated with the use of antiretroviral therapy (ART) are reported. Redistribution of body fat has been associated with treatment and is characterized by morphological changes, also known as lipodystrophy. The complications of metabolic and morphological changes in these individuals seem to increase the risk of cardiovascular disease. Adipocytokines are proteins that have essential functions in biological processes, in which the levels of these proteins are related to the pathogenesis of metabolic syndrome (MS) and cardiovascular disease. Recent studies have shown that such levels are generally modified in PLWHA, regardless of whether the treatment is established or not. An application of methods for body fat estimation in patients with fat redistribution, as in the case of aids, especially those that quantify body fat by segments, appears to clarify these alterations and plays an important role in the development of multiprofessional treatment. Objectives: This investigation was carried out to compare and correlate body composition, biochemical metabolic parameters, and levels of adipocytokines and cytokines of PLWHA, with and without lipodystrophy, with individuals with negative HIV serology and stratified by sex. Material and Methods: This is a cross-sectional study in which body composition, metabolic and anthropometric changes, and levels of adipocytokines of 110 individuals were assessed. These individuals were paired in sex, age, and body mass index (BMI) and subdivided into three groups: PLWHA with and without a clinical diagnosis of lipodystrophy associated with HIV, and a group control. Results: Collinearity was identified both in the general sample and for genders of the waist-to-height ratio (WHtR) with all anthropometric parameters, except for muscle mass. The results show strong association between IFN-γ and TNF-α both in the general sample and for genders and moderate correlation between leptin and fasting glucose for women; worsening of the triglyceride profile in both women with lipodystrophy compared with the control group and men without lipodystrophy compared with the control group; higher serum TNF-α values among men without lipodystrophy compared to those with HIV-associated lipodystrophy (HALS). Conclusions: The results of this study underline that, considering the manifestations of the syndrome, these patients have a high-risk endocrine metabolic profile for cardiovascular events.
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Affiliation(s)
- Lívia Bertazzo Sacilotto
- Department of Infectology, Dermatology, Diagnostic Imaging, and Radiotherapy, Botucatu Medical School, São Paulo State University (UNESP), São Paulo, Brazil
| | - Silvia Justina Papini
- Department of Nursing, Botucatu Medical School, São Paulo State University (UNESP), São Paulo, Brazil
| | - Adriana Lucia Mendes
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), São Paulo, Brazil
| | - Mariana Gatto
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), São Paulo, Brazil
| | - Paulo Câmara Marques Pereira
- Department of Infectology, Dermatology, Diagnostic Imaging, and Radiotherapy, Botucatu Medical School, São Paulo State University (UNESP), São Paulo, Brazil
| | - José Eduardo Corrente
- Department of Biostatistics, Institute of Biosciences, São Paulo State University (UNESP), São Paulo, Brazil
| | - Julhiany de Fátima da Silva
- Department of Infectology, Dermatology, Diagnostic Imaging, and Radiotherapy, Botucatu Medical School, São Paulo State University (UNESP), São Paulo, Brazil
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Beraldo RA, Santos APD, Guimarães MP, Vassimon HS, Paula FJAD, Machado DRL, Foss-Freitas MC, Navarro AM. Body fat redistribution and changes in lipid and glucose metabolism in people living with HIV/AIDS. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 20:526-536. [PMID: 29160443 DOI: 10.1590/1980-5497201700030014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 02/23/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The HIV lipodystrophy syndrome is characterized by changes in metabolism, and body composition that increase cardiovascular risk of people living with HIV/AIDS (PLWHA) using highly active antiretroviral therapy (HAART). OBJECTIVE To assess the prevalence of lipodystrophy and changes in lipid and glucose metabolism in PLWHA in use of HAART. METHODS For the anthropometric evaluation we measured weight, height and abdominal circumference (AC). For the lipodystrophy evaluation we conducted physical examination (subjective) and the (objective) examination of absorptiometry with X-ray dual energy (DEXA) by fat mass ratio (FMR). We also conducted lipid profile tests and fasting glucose and used the criteria suggested by The National Cholesterol Education Program III for metabolic disorders classification. RESULTS The final sample consisted of 262 patients with a mean age of 44.3 ± 10.2 years. Lipodystrophy, according to the physical examination, was present in 47.7% (95%CI 41.7 - 53.8) of patients, while the prevalence using FMR (DEXA) was 40.8% (95%CI 33.1 - 48.5). Most (53.0%; 95%CI 47.0 - 59.1) of the patients showed increased abdominal adiposity according to AC. The most prevalent metabolic alterations were reduced HDL (67.6%; 95%CI 61.9 - 73.2) and hypertriglyceridemia (55.7%; 95%CI 49.7 - 61.7). CONCLUSION The high prevalence of lipodystrophy and changes in lipid and glucose metabolism show the importance of early intervention in this group of patients to prevent cardiovascular complications.
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Affiliation(s)
- Rebeca Antunes Beraldo
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil
| | - André Pereira Dos Santos
- Programa Interunidades de Doutoramento, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil
| | - Mariana Palma Guimarães
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil
| | | | | | - Dalmo Roberto Lopes Machado
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil.,Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil
| | - Maria Cristina Foss-Freitas
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil
| | - Anderson Marliere Navarro
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brasil
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Srdic D, Khawla AM, Soldatovic I, Nikolic J, Jevtovic D, Nair D, Dragovic G. Correlation of Leptin, Adiponectin, and Resistin Levels in Different Types of Lipodystrophy in HIV/AIDS Patients. Metab Syndr Relat Disord 2017; 15:153-159. [PMID: 28339344 DOI: 10.1089/met.2016.0068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Leptin, adiponectin, and resistin may play an important role in the development of lipodystrophy (LD) in HIV/AIDS patients. The aim of this study was to correlate levels of leptin, adiponectin, and resistin between HIV/AIDS patients with LD and without lipodystrophy (non-LD), as well as between subgroups of LD [lipoatrophy (LA), lipohypertrophy (LH), and mixed fat redistribution (MFR)] and non-LD patients. METHODS Cross-sectional study of 66 HIV/AIDS patients. Serum levels of leptin, adiponectin, and resistin were measured. The associations between adipocytokine levels and metabolic variables were estimated by Spearman correlation. Analysis of covariance with bootstrapping method was used to examine the relationship between adiponectin and leptin and lipodystrophy categories. RESULTS The LD was observed in 29 (44%) patients, while 15 (52%) of them had LA, 4 (14%) had LH, and 10 (34%) patients had MFR. No significant differences regarding leptin, adiponectin, and resistin levels, between LD and non-LD patients, were observed. LH patients had significantly higher levels of leptin and adiponectin in comparison with non-LD patients (P = 0.039, P = 0.011, respectively). Within the LD group, LA patients had significantly lower levels of leptin (LA vs. LH, P = 0.020; LA vs. MFR, P = 0.027), while LH patients had significantly higher levels of adiponectin (LH vs. LA, P = 0.027; LH vs. MFR, P = 0.028). Correlation of adiponectin with LD remains significant in the LH subgroup after adjustment for age, body mass index, cystatin-C, plasminogen activator inhibitor-1 (PAI-1), and interferon gamma (IFN-γ) (P = 0.001). CONCLUSIONS Adiponectin and leptin levels differ significantly between LH patients and non-LD patients, as well as between the LD subgroups. Adiponectin may be a more useful marker of LD in HIV/AIDS patients.
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Affiliation(s)
- Danica Srdic
- 1 Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Al Musalhi Khawla
- 2 Department of Clinical Biochemistry, Royal Free Hospital, University College London , London, United Kingdom
| | - Ivan Soldatovic
- 3 Institute for Biomedical Statistics, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Jelena Nikolic
- 4 Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Djordje Jevtovic
- 4 Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade , Belgrade, Serbia
| | - Devaki Nair
- 2 Department of Clinical Biochemistry, Royal Free Hospital, University College London , London, United Kingdom
| | - Gordana Dragovic
- 1 Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade , Belgrade, Serbia
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Dragović G, Dimitrijević B, Khawla AM, Soldatović I, Andjić M, Jevtović D, Nair D. Lower levels of IL-4 and IL-10 influence lipodystrophy in HIV/AIDS patients under antiretroviral therapy. Exp Mol Pathol 2017; 102:210-214. [PMID: 28189545 DOI: 10.1016/j.yexmp.2017.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/04/2017] [Accepted: 02/07/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The role of interleukins in the pathogenesis of lipodystrophy in HIV/AIDS-patients is still not understood. The aim of this study was to evaluate the relationship between serum levels of interleukins between HIV/AIDS-patients with or without lipodystrophy, as well as between different subgroups of lipodystrophy (lipoatrophy, lipohypertrophy, mixed-fat-redistribution) and patients without lipodystrophy. METHODS Cross-sectional study of 66 HIV/AIDS patients, all Caucasians. Serum levels of interleukins (IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10) were measured using Cytokine-Array-1 on Evidence Investigator, Biochip Array Technology. The associations between interleukins and anthropometric and metabolic variables were estimated by Spearman-correlation. Analysis of covariance with bootstrapping method (ACBM) was used to examine relationship between interleukins and lipodystrophy categories adjusted for confounding variables. RESULTS The lipodystrophy was observed in 29 (44%) patients, while 15 (52%) had lipoatrophy, 4 (14%) lipohypertrophy and 10 (34%) patients had mixed fat redistribution. There were 37 (56%) patients without lipodystrophy. Significantly lower levels of IL-4 and IL-10 were observed in lipodystrophy vs. non-lipodystrophy (p=0.008; p=0.027, respectively). No differences were found relating IL-1α, IL-1β, IL-2, IL-6 and IL-8 levels in lipodystrophy vs. non-lipodystrophy. In patient subgroup with lipoatrophy, significantly lower levels of IL-4 and IL-10 were found when compared to non-lipodystrophy (p=0.043; p=0.031, respectively). In lipohypertrophy subgroup significantly lower levels of IL-4 were found when compared to non-lipodystrophy (p=0.003). In order to estimate the correlation of IL-4 and IL-10 and the presence of lipodystrophy, ACBM showed that correlation of IL-4 levels in patients with lipodystrophy remains statistically significant (p=0.004) in all types of lipodystrophy: lipoatrophy, lipohypertrophy and mix-fat-redistribution (p=0.027; p=0.009; p=0.017, respectively) after adjustment for age, BMI. CONCLUSIONS IL-4 and IL-10 levels were significantly lower in lipodystrophy vs. non-lipodystrophy. According to our knowledge, we showed for the first time significant correlation between IL-4 levels and lipodystrophy development in HIV/AIDS patients.
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Affiliation(s)
- Gordana Dragović
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Božana Dimitrijević
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Al Musalhi Khawla
- Department of Clinical Biochemistry, Royal Free Hospital, London, United Kingdom; University College London, London, United Kingdom
| | - Ivan Soldatović
- Institute for Biomedical Statistics, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mladen Andjić
- Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Djordje Jevtović
- Infectious and Tropical Diseases Hospital, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Devaki Nair
- Department of Clinical Biochemistry, Royal Free Hospital, London, United Kingdom; University College London, London, United Kingdom
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Proposed ratios and cutoffs for the assessment of lipodystrophy in HIV-seropositive individuals. Eur J Clin Nutr 2014; 69:274-8. [PMID: 25074393 DOI: 10.1038/ejcn.2014.149] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 06/23/2013] [Accepted: 06/26/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To propose objective ratios using anthropometry and dual-energy X-ray absorptiometry (DXA) and to suggest cutoff points for them in order to classify lipodystrophy in male patients. METHODS It is a cross-sectional study. DXA was applied and anthropometric measurements were performed in 100 men on highly active antiretroviral therapy. Receiver operating characteristic curves were used to propose cutoffs. Individuals were divided in without (lipo-) or with (lipo+) lipodystrophy and their metabolic parameters were compared. RESULTS The following ratios were proposed: fat mass ratio by DXA (FMR), waist thigh ratio (WTR), waist calf ratio (WCR), and arm to trunk ratio (ATR). The best cutoffs observed for FMR, WTR and ATR were 1.26, 1.74 and 2.08, respectively. Using the proposed cutoff for FMR, we observed worse metabolic profile, with increased tryglicerides, fasting serum glucose and more hypercholesterolemia in the lipo+ group. WTR and ATR showed a significant correlation with FMR. CONCLUSIONS Anthropometric ratios (WTR/ATR) and FMR can be used to aid the diagnosis of lipodystrophy in order to contribute to a more accurate and earlier diagnosis permitting intervention and even preventing metabolic disturbances.
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Della Justina LB, Luiz MC, Maurici R, Schuelter-Trevisol F. Prevalence and factors associated with lipodystrophy in AIDS patients. Rev Soc Bras Med Trop 2014; 47:30-7. [DOI: 10.1590/0037-8682-0240-2013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 01/28/2014] [Indexed: 12/13/2022] Open
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Freitas P, Carvalho D, Santos AC, Matos MJ, Madureira AJ, Marques R, Martinez E, Sarmento A, Medina JL. Prevalence of obesity and its relationship to clinical lipodystrophy in HIV-infected adults on anti-retroviral therapy. J Endocrinol Invest 2012; 35:964-70. [PMID: 22186163 DOI: 10.3275/8187] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Combination antiretroviral therapy (cART) is associated with lipodystrophy (lipoatrophy and lipoaccumulation) and several metabolic abnormalities that together can contribute to an increased cardiovascular risk. The aim of this study was to evaluate the prevalence of obesity in patients on cART according to the presence of clinical lipodystrophy (CL) and to analyze factors associated with obesity. METHODS We evaluated 368 HIV-infected adults on cART. RESULTS CL was present in 59.0%. Independently of gender, patients with CL were more frequently underweight [5.7% (21/368)] and of normal weight [47.3% (174/368)], and less frequently overweight [33.2% (122/368)] or obese [13.9% (51/368)]. Mean body mass index was higher in patients with abdominal prominence regardless of the presence of clinical lipoatrophy. Patients with CL had lower waist circumference, higher waist/hip and fat mass ratio and lower total and subcutaneous fat, without significant difference in visceral fat but with a higher visceral/subcutaneous fat ratio, as evaluated by CT at abdominal level. CL was significantly less frequent in overweight [odds ratio (OR)=0.21, 95% confidence interval (CI): 0.05-0.92] and obese (OR=0.05, 95%CI: 0.01-0.26) patients, when compared to underweight ones, independent of age, gender, duration of infection, cART regimen, virological suppression, and HIV-infection risk factor. CONCLUSIONS Being overweight or obese is highly prevalent in HIV-infected patients on cART. Patients with CL were more frequently under- or normal weight, and less frequently overweight or obese. Obesity is a condition that should be considered in HIV patients on cART.
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Affiliation(s)
- P Freitas
- Department of Endocrinology, Hospital de São João and University of Porto Medical School, Alameda Hernâni Monteiro, Porto, Portugal.
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Segatto AFM, Freitas Junior IF, Santos VRD, Alves KCP, Barbosa DA, Portelinha Filho AM, Monteiro HL. Lipodystrophy in HIV/AIDS patients with different levels of physical activity while on antiretroviral therapy. Rev Soc Bras Med Trop 2012; 44:420-4. [PMID: 21860886 DOI: 10.1590/s0037-86822011000400004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 04/07/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Lipodystrophy is related to the use of highly active antiretroviral therapy (HAART) and can cause aesthetic stigma and increase the risk of developing cardiovascular diseases. Physical activity may be a valid alternative for the treatment and prevention of lipodystrophy. However, few studies address this issue. The objective of this study was to assess lipodystrophy related to highly active antiretroviral therapy in HIV/AIDS patients with different physical activity habits. METHODS The sample was composed of 42 HIV/AIDS patients taking HAART medication who were visiting the Counseling and Testing Center (CTC) in Presidente Prudente. The level of physical activity was obtained using the International Physical Activity Questionnaire (IPAQ); lipodystrophy was diagnosed using a self-report questionnaire that was administered to the patient and then followed up by medical confirmation. The percentage of trunk fat was estimated by dual X-Ray absorptiometry (DEXA). Information about sex, age, length of HAART treatment, CD4+ T lymphocyte count (CD4) and viral load was also collected. RESULTS A higher prevalence of lipodystrophy was observed in the sedentary group when compared to the physically active group, which indicates that physical activity may be a protective factor in relation to the occurrence of lipodystrophy. The group that had a higher CD4 had a higher proportion of lipodystrophy and a higher proportion of younger and physically active individuals. The patients with lipodystrophy had a higher percentage of trunk fat and were more sedentary than active individuals. CONCLUSIONS A physically active lifestyle has a protective effect against the occurrence of lipodystrophy related to HAART.
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Affiliation(s)
- Aline Francielle Mota Segatto
- Programa de Mestrado em Fisioterapia, Universidade Estadual Paulista Julio de Mesquita Filho, Presidente Prudente, SP, Brasil.
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Freitas P, Carvalho D, Santos AC, Mesquita J, Correia F, Xerinda S, Marques R, Martinez E, Sarmento A, Medina JL. Assessment of body fat composition disturbances by bioimpedance analysis in HIV-infected adults. J Endocrinol Invest 2011; 34:e321-9. [PMID: 21737998 DOI: 10.3275/7841] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
HIV-lipodystrophy syndrome is characterized by different patterns of body fat distribution (BFD) which are identified by clinical and body composition (BC) assessment, including bioimpedance analysis (BIA). Our aim was to compare BC in HIV-infected patients on combination antiretroviral therapy (cART) according to 4 distinct phenotypes of BFD (G1-no lipodystrophy, G2-isolated central fat accumulation, G3-lipoatrophy, G4-mixed forms of lipodystrophy) and assessed factors associated with them. Anthropometry and BIA were performed in 344 HIV-1 patients. G2 and G4 phenotype patients had significantly higher fat mass (FM) but no differences were observed in fat-free mass (FFM) and total body water among the 4 phenotypes. Significant negative associations were found between the presence of lipoatrophy and female gender, body mass index (BMI), waist (WC), hip (HC) and thigh circumferences, and total body FM estimated by BIA. After adjustment for gender, cART duration and BMI, G3 had significant lower WC [odds ratio (OR)=0.84; 0.78- 0.90] and HC (OR=0.88; 0.81-0.96) mean. Independently of gender, cART duration and BMI, G2 remained significantly associated with higher WC (OR=1.11; 1.05-1.18) and HC (OR=1.15; 1.07-1.23) mean, and with FM estimated by BIA [FM as %, OR=1.17 (1.09-1.26); and FM as kg, OR=1.15 (1.06- 1.25)]. There was a significant positive association between G4 and female gender (OR=1.66; 1.01-2.75), BMI (OR=1.10; 1.04-1.17) and WC (OR=1.15; 1.09-1.21). The similar FFM along the BFD spectrum describes the actual BC of these patients without sarcopenia. In a clinical setting, BIA is an easy and useful tool to evaluate fat mass and FFM and gives us a picture of BC that was not possible with anthropometry.
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Affiliation(s)
- P Freitas
- Endocrinology Department, Hospital de São João and University of Porto Medical School, Alameda Hernâni Monteiro, 4200 Porto, Portugal.
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Nair RG, Owotade FJ, Leao JC, Hegarty AM, Hodgson TA. Coinfections associated with human immunodeficiency virus infection: workshop 1A. Adv Dent Res 2011; 23:97-105. [PMID: 21441489 DOI: 10.1177/0022034511399916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The importance of opportunistic pathogens in HIV disease has been demonstrated from the onset of the epidemic. This workshop aimed to review the evidence for the role of oral microorganisms in HIV-related periodontal disease and HIV transmission and the effect of HIV therapy on periodontal disease. Despite being a common copathogen, tuberculosis seems to have limited oral presentation. The oral manifestations seem to have little impact on the individual and, once diagnosed, are responsive to chemotherapy. The participants debated the available evidence on the role of microorganisms and whether further research was warranted and justified. Although the effects of lipodystrophy on facial aesthetics may be profound and may markedly affect quality of life, there is no evidence to suggest a direct effect on the oral cavity. Though of interest to oral health care workers, lipodystrophy and associated metabolic syndromes were thought to be further investigated by other, more appropriate groups.
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Affiliation(s)
- R G Nair
- Oral Medicine, School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
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Juchem GMV, Lazzarotto AR. Treinamento físico na síndrome lipodistrófica: revisão sistemática. REV BRAS MED ESPORTE 2010. [DOI: 10.1590/s1517-86922010000400015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Com a cronicidade da infecção pelo HIV, a partir do uso da terapia antirretroviral combinada (TARV), o indivíduo torna-se predisposto às alterações metabólicas e corporais denominadas síndrome lipodistrófica, que têm como consequência o risco aumentado para doenças cardiovasculares. Tornam-se necessários estudos com viabilidades terapêuticas com o intuito de melhorar a qualidade de vida destes pacientes. Neste contexto, o treinamento físico deve ser abordado como terapêutica para minimizar os efeitos deletérios da TARV. O objetivo desse artigo foi revisar na literatura as evidências científicas sobre o treinamento físico na síndrome lipodistrófica. O método utilizado foi uma revisão sistemática com a localização de artigos publicados entre 2000 e 2008 nas bases de dados PubMed e SciELO. As evidências científicas encontradas nos estudos analisados indicam que a maioria dos estudos, independente do tipo de treinamento, obtiveram melhoria significativa na composição corporal. Dessa forma, tornam-se necessário mais estudos investigando o treinamento físico no perfil lipídico, na resistência a insulina e nas alterações glicêmicas em pessoas vivendo com HIV/Aids.
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