{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:45:30Z","timestamp":1793317530040,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:00:00Z","timestamp":1568764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:00:00Z","timestamp":1568764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The aim of this study was to establish the prevalence of lipodystrophy and its association to cumulative exposure to antiretroviral drugs.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>We conducted a cross sectional study in all HIV- infected patients attending the HIV clinic in the Centre hospitalier universitaire de Montr\u00e9al (CHUM) with DEXA scan. Lipodystrophy was defined as a trunk\/limb fat ratio\u2009\u2265\u20091.5. Association between cumulative exposure to antiretroviral (measured in years of use) with trunk\/limb fat ratio (coded as a continuous variable) was assessed using univariate and multivariate linear regression for each antiretroviral drug with at least 40 exposed patients.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One hundred sixty-six patients were included. Seventy-five percent were male, median age was 56\u2009years, 67% were Caucasian. Overall, prevalence of lipodystrophy was 47%, with a mean trunk\/limb fat ratio of 1.87, SD\u2009=\u20091.03, min\u2009=\u20090.6 and max\u2009=\u20095.87. Each 10-year increase in age and HIV infection duration was associated with an average increase of 0.24 and 0.34 for the trunk\/limb fat ratio respectively. (<jats:italic>p<\/jats:italic>\u2009=\u20090.003, <jats:italic>p<\/jats:italic>\u2009=\u20090.002, respectively) Patients classified as lipodystrophic were more likely to be diabetic (50 vs. 28%, <jats:italic>p<\/jats:italic>\u2009=\u20090.07) and to have dyslipidemia (47 vs. 19%, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). According to viral load at DEXA test, each one log increase was associated with less probability (0.7) of lipodystrophy. (p\u2009=\u20090.01) Among ARV drugs tested, there was an association between years of use of d4T, ritonavir and raltegravir and higher trunk\/limb fat ratio (indicating more lipodystrophy) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Lipodystrophy is very common in HIV infected patients and is correlated with duration of some new antiretroviral drugs.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-019-4446-9","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T13:04:57Z","timestamp":1568811897000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Association between lipodystrophy and length of exposure to ARTs in adult HIV-1 infected patients in Montreal"],"prefix":"10.1186","volume":"19","author":[{"given":"Ahmad","family":"Alikhani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Morin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Matte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouriya","family":"Alikhani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Tremblay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Durand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"key":"4446_CR1","first-page":"559","volume":"10","author":"MD Alves","year":"2014","unstructured":"Alves MD, Brites C, Sprinz E. HIV-associated lipodystrophy: a review from a Brazilian perspective. Ther Clin Risk Manag. 2014;10:559\u201366.","journal-title":"Ther Clin Risk Manag"},{"issue":"9","key":"4446_CR2","doi-asserted-by":"publisher","first-page":"1252","DOI":"10.1111\/j.1742-1241.2010.02424.x","volume":"64","author":"M Aboud","year":"2010","unstructured":"Aboud M, Elgalib A, Pomeroy L, Panayiotakopoulos G, Skopelitis E, Kulasegaram R, et al. Cardiovascular risk evaluation and antiretroviral therapy effects in an HIV cohort: implications for clinical management: the CREATE 1 study. Int J Clin Pract. 2010;64(9):1252\u20139.","journal-title":"Int J Clin Pract"},{"issue":"11","key":"4446_CR3","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1097\/00002030-200307250-00012","volume":"17","author":"JR Marins","year":"2003","unstructured":"Marins JR, Jamal LF, Chen SY, Barros MB, Hudes ES, Barbosa AA, et al. Dramatic improvement in survival among adult Brazilian AIDS patients. AIDS (London, England). 2003;17(11):1675\u201382.","journal-title":"AIDS (London, England)"},{"issue":"8","key":"4446_CR4","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1001\/jamainternmed.2013.3728","volume":"173","author":"MS Freiberg","year":"2013","unstructured":"Freiberg MS, Chang CC, Kuller LH, Skanderson M, Lowy E, Kraemer KL, et al. HIV infection and the risk of acute myocardial infarction. JAMA Intern Med. 2013;173(8):614\u201322.","journal-title":"JAMA Intern Med"},{"issue":"13","key":"4446_CR5","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1007\/s40265-013-0108-1","volume":"73","author":"G Guaraldi","year":"2013","unstructured":"Guaraldi G, Stentarelli C, Zona S, Santoro A. HIV-associated lipodystrophy: impact of antiretroviral therapy. Drugs. 2013;73(13):1431\u201350.","journal-title":"Drugs."},{"key":"4446_CR6","unstructured":"The epidemiology of HIV in Canada [Internet]. 2014."},{"issue":"2","key":"4446_CR7","doi-asserted-by":"publisher","first-page":"e89088","DOI":"10.1371\/journal.pone.0089088","volume":"9","author":"P Domingo","year":"2014","unstructured":"Domingo P, Gutierrez Mdel M, Gallego-Escuredo JM, Torres F, Mateo GM, Villarroya J, et al. Effects of switching from stavudine to raltegravir on subcutaneous adipose tissue in HIV-infected patients with HIV\/HAART-associated lipodystrophy syndrome (HALS). A clinical and molecular study. PLoS One. 2014;9(2):e89088.","journal-title":"PLoS One"},{"issue":"8","key":"4446_CR8","doi-asserted-by":"publisher","first-page":"746","DOI":"10.2298\/VSP121016022D","volume":"71","author":"G Dragovic","year":"2014","unstructured":"Dragovic G, Danilovic D, Dimic A, Jevtovic D. Lipodystrophy induced by combination antiretroviral therapy in HIV\/AIDS patients: a Belgrade cohort study. Vojnosanit Pregl. 2014;71(8):746\u201350.","journal-title":"Vojnosanit Pregl"},{"issue":"3","key":"4446_CR9","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1046\/j.1468-1293.2003.00159.x","volume":"4","author":"J Miller","year":"2003","unstructured":"Miller J, Carr A, Emery S, Law M, Mallal S, Baker D, et al. HIV lipodystrophy: prevalence, severity and correlates of risk in Australia. HIV medicine. 2003;4(3):293\u2013301.","journal-title":"HIV medicine"},{"key":"4446_CR10","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s12981-015-0061-z","volume":"12","author":"CM Verolet","year":"2015","unstructured":"Verolet CM, Delhumeau-Cartier C, Sartori M, Toma S, Zawadynski S, Becker M, et al. Lipodystrophy among HIV-infected patients: a cross-sectional study on impact on quality of life and mental health disorders. AIDS Res Ther. 2015;12:21.","journal-title":"AIDS Res Ther"},{"issue":"1","key":"4446_CR11","first-page":"21","volume":"17","author":"M Sension","year":"2015","unstructured":"Sension M, Deckx H. Lipid metabolism and lipodystrophy in HIV-1-infected patients: the role played by nonnucleoside reverse transcriptase inhibitors. AIDS Rev. 2015;17(1):21\u201336.","journal-title":"AIDS Rev"},{"issue":"1","key":"4446_CR12","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1097\/00002030-200001070-00006","volume":"14","author":"JQ Purnell","year":"2000","unstructured":"Purnell JQ, Zambon A, Knopp RH, Pizzuti DJ, Achari R, Leonard JM, et al. Effect of ritonavir on lipids and post-heparin lipase activities in normal subjects. AIDS (London, England). 2000;14(1):51\u20137.","journal-title":"AIDS (London, England)"},{"issue":"13","key":"4446_CR13","doi-asserted-by":"publisher","first-page":"2050","DOI":"10.1001\/archinte.160.13.2050","volume":"160","author":"S Tsiodras","year":"2000","unstructured":"Tsiodras S, Mantzoros C, Hammer S, Samore M. Effects of protease inhibitors on hyperglycemia, hyperlipidemia, and lipodystrophy: a 5-year cohort study. Arch Intern Med. 2000;160(13):2050\u20136.","journal-title":"Arch Intern Med"},{"issue":"3","key":"4446_CR14","first-page":"291","volume":"64","author":"A Degli Antoni","year":"2015","unstructured":"Degli Antoni A, Weimer LE, Fragola V, Giacometti A, Sozio F. A reduction grade of lipodystrophy and limited side effects after HAART regimen with Raltegravir, lamivudine, Darunavir and ritonavir in an HIV-1 infected patient after six years of antiretroviral therapy. West Indian Med J. 2015;64(3):291\u20133.","journal-title":"West Indian Med J"},{"issue":"7","key":"4446_CR15","first-page":"OC05","volume":"9","author":"NS Kumar","year":"2015","unstructured":"Kumar NS, Shashibhushan J, Malappa VK, Vishwanatha H, Menon M. Lipodystrophy in human immunodeficiency virus (HIV) patients on highly active antiretroviral therapy (HAART). J Clin Diagn Res. 2015;9(7):OC05\u20138.","journal-title":"J Clin Diagn Res"},{"issue":"11","key":"4446_CR16","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1097\/00002030-200107270-00008","volume":"15","author":"KA Lichtenstein","year":"2001","unstructured":"Lichtenstein KA, Ward DJ, Moorman AC, Delaney KM, Young B, Palella FJ Jr, et al. Clinical assessment of HIV-associated lipodystrophy in an ambulatory population. AIDS (London, England). 2001;15(11):1389\u201398.","journal-title":"AIDS (London, England)"},{"issue":"10","key":"4446_CR17","doi-asserted-by":"publisher","first-page":"e77138","DOI":"10.1371\/journal.pone.0077138","volume":"8","author":"A Martin","year":"2013","unstructured":"Martin A, Moore CL, Mallon PW, Hoy JF, Emery S, Belloso WH, et al. HIV lipodystrophy in participants randomised to lopinavir\/ritonavir (LPV\/r) +2-3 nucleoside\/nucleotide reverse transcriptase inhibitors (N(t)RTI) or LPV\/r + raltegravir as second-line antiretroviral therapy. PLoS One. 2013;8(10):e77138.","journal-title":"PLoS One"},{"issue":"2","key":"4446_CR18","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1038\/ejcn.2014.149","volume":"69","author":"RA Beraldo","year":"2015","unstructured":"Beraldo RA, Vassimon HS, Aragon DC, Navarro AM, Albuquerque de Paula FJ, Foss-Freitas MC. Proposed ratios and cutoffs for the assessment of lipodystrophy in HIV-seropositive individuals. Eur J Clin Nutr. 2015;69(2):274\u20138.","journal-title":"Eur J Clin Nutr"},{"key":"4446_CR19","unstructured":"HyLown Consulting LLC. Power and sample size Atlanta, GA2013\u20132018 [Available from: \n                    http:\/\/powerandsamplesize.com\/\n                    \n                  ."},{"issue":"9170","key":"4446_CR20","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1016\/S0140-6736(98)08468-2","volume":"353","author":"A Carr","year":"1999","unstructured":"Carr A, Samaras K, Thorisdottir A, Kaufmann GR, Chisholm DJ, Cooper DA. Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet (London, England). 1999;353(9170):2093\u20139.","journal-title":"Lancet (London, England)"},{"issue":"5","key":"4446_CR21","doi-asserted-by":"publisher","first-page":"e63623","DOI":"10.1371\/journal.pone.0063623","volume":"8","author":"R de Waal","year":"2013","unstructured":"de Waal R, Cohen K, Maartens G. Systematic review of antiretroviral-associated lipodystrophy: lipoatrophy, but not central fat gain, is an antiretroviral adverse drug reaction. PLoS One. 2013;8(5):e63623.","journal-title":"PLoS One"},{"issue":"7","key":"4446_CR22","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1093\/cid\/ciw017","volume":"62","author":"GA McComsey","year":"2016","unstructured":"McComsey GA, Moser C, Currier J, Ribaudo HJ, Paczuski P, Dube MP, et al. Body composition changes after initiation of Raltegravir or protease inhibitors: ACTG A5260s. Clin Infect Dis. 2016;62(7):853\u201362.","journal-title":"Clin Infect Dis"},{"issue":"9","key":"4446_CR23","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1089\/apc.2012.0135","volume":"26","author":"JE Lake","year":"2012","unstructured":"Lake JE, McComsey GA, Hulgan TM, Wanke CA, Mangili A, Walmsley SL, et al. A randomized trial of Raltegravir replacement for protease inhibitor or non-nucleoside reverse transcriptase inhibitor in HIV-infected women with lipohypertrophy. AIDS Patient Care STDs. 2012;26(9):532\u201340.","journal-title":"AIDS Patient Care STDs"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-4446-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12879-019-4446-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-019-4446-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T12:13:21Z","timestamp":1600344801000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-019-4446-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,18]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["4446"],"URL":"https:\/\/doi.org\/10.1186\/s12879-019-4446-9","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,18]]},"assertion":[{"value":"12 October 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 September 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 September 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All patients consented (written consent) to contribute data to the database, which was approved by the CHUM research ethic board. (Comit\u00e9 d\u2019\u00e9thique de la Recherche du Centre Hospitalier Universitaire de Montr\u00e9al, and file number: CE 08.030).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"820"}}