Journal sur le SIDA et la recherche clinique

Prevalence of HIV-Associated Lipodystrophy in Brazil: A Systematic Review of the Literature

Abstract

Lunara Basqueroto Della Justina, Daisson Jose Trevisol and Fabiana Schuelter-Trevisol

Background: Currently, AIDS is considered a chronic, treatable disease for those who have access to Highly Active Antiretroviral Therapy (HAART). However, the decline in morbidity and mortality rates with an increase in life expectancy attributable to drug treatment has adverse effects associated with its continued use, such as changes in the body-fat distribution and metabolic abnormalities that define lipodystrophy syndrome. Objective: To conduct a systematic review of the prevalence of and methods used for defining and grading lipodystrophy in individuals living with HIV in Brazil. Methods: The electronic search was performed in Medline, Lilacs, SciELO, and thesis and dissertation databases. Original observational studies that had determined the prevalence of lipodystrophy in HIV-infected patients were included. Results: 103 articles were retrieved, and 16 were included in this review. The prevalence of lipodystrophy ranged between 32.4% and 88.6%. The methods used to assess lipodystrophy were: (i) Patient self-report and physician examination; (ii) patient self-report alone; (iii) physician examination and anthropometric measurements; (iv) patient self-report and anthropometric measurements; and (v) physician examination alone. Conclusion: The weighted average prevalence of lipodystrophy was 53.5%, and the most commonly used method to assess lipodystrophy was the patient self-report and physician examination. Further longitudinal and diagnostic studies should be conducted to determine the incidence and accuracy of lipodystrophy.