The fat redistribution syndrome in patients infected with HIV: Measurements of body shape abnormalities

Objective To describe the body shape changes in the syndrome of fat redistr ibution or lipodystrophy seen in patients infected with HIV. Design An objective description of patients with HIV with fat redistributio n syndrome. Body height, weight, shape, and composition were measured by an thropometrics and biolectrical impedance analysis by a single observer. Cli nical data were collected by chart review. Subjects/setting Thirty-nine patients with HIV receiving primary HIV care a t a university hospital-affiliated infectious disease clinic who presented with complaints of body shape changes or who were referred by their primary care providers for body shape changes. Analysis Descriptive statistics were performed. Results Four of the 39 patients (10%) had not used protease inhibitor thera py. HIV status (by clinical presentation, CD4 and VL) varied widely. Labora tory abnormalities were moderate. Percent body fat differed widely when mea sured by bioelectrical impedance analysis and anthropometry (23% vs 13%). T he mean body mass index was 25.6 kg/m(2) for men and 25.8 kg/m(2) for women . The mean waist/hip ratio was above normal, at 1.02. The mean mid-arm circ umference and triceps skinfolds were below national standards for both men (30.4 em and 8.1 mm, respectively) and women (26.7 cm and 7.5 mm, respectiv ely). Nine patients (23%) had an increased dorso-cervical pad. Seventeen pa tients returned for follow-up measurements at 3 months; no significant diff erences were found between baseline and follow-up measurements. Conclusions The waist/hip ratio, mid-arm and mid-thigh circumference, and t riceps skinfolds were useful measures to define and follow the fat redistri bution syndrome in patients with HIV. These body composition changes were n ot transitory in this short follow-up period.