{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T17:07:54Z","timestamp":1753895274697,"version":"3.41.2"},"reference-count":0,"publisher":"Wiley","issue":"4S3","license":[{"start":{"date-parts":[[2014,11,2]],"date-time":"2014-11-02T00:00:00Z","timestamp":1414886400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Morphological and metabolic complications in HIV patients on antiretroviral therapy remain a challenge. While new cases of lipoatrophy (LA) disappear, irreducible central lipohypertrophy (LH) and metabolic complications require highly specialized management. We described a day hospital dedicated to lipodystrophy (LD) and metabolic disorders in HIV patients on treatment in Geneva, Switzerland, with a focus on LH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>The \u201cGroupe Lipo &amp; Metabolism\u201d is a multidisciplinary consultation where patients undergo a standard evaluation including questionnaire, physical examination, dual\u2010energy x\u2010ray absorptiometry (DEXA) and L5\u2010level CT scans, blood tests and consultations with various specialists. Based on prospectively maintained data, we describe clinical, biological and radiological characteristics of patients \u226518 years who attended the consultation between 2008 and 2013. We defined LH by CT scan, the gold standard method, as abdominal visceral adipose tissue (VAT) \u2265130 cm<jats:sup>2<\/jats:sup>, value associated with increased risk of cardiovascular event.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 195 patients attended the consultation during study period. Reasons for referral included LH in 28.3%, LA in 25% and mixed syndrome in 15.5% of cases. Metabolic disorders accounted for 19% of referrals with or without LD features. Among patients with a CT scan performed (n=183), 46 (25%) had LH with a VAT \u2265130 cm<jats:sup>2<\/jats:sup>. In this population, mean age was 49.1 years and 53.6% were male. HIV viral load was &lt;50 cp\/ml in 87% of patients. Mean body mass index was 24.6 kg\/m<jats:sup>2<\/jats:sup>. Mean waist to hip ratio (WHR) was 0.98 for males and 0.89 for females. A total of 9.8%, 29.5% and 35% of patients had abnormal levels of total cholesterol (\u22656.5 mmol\/L), triglycerides (\u22652.0 mmol\/L) and HDL cholesterol (\u22641.0 mmol\/L), respectively. Mean fasting glycaemia was 5.7 mmol\/L and HbA1c was &gt;6% in 10.5% of patients. Vitamin\u2010D level was &lt;75 nmol\/L in 70.7% of patients. Respectively 31.2% and 12.1% of patients had osteopenia and osteoporosis on the spine and 44.8% and 6.6% on the hip neck. Factors associated with a VAT\u2265130 cm<jats:sup>2<\/jats:sup> included male gender (OR 3.7 [95% CI 1.7\u20138.2] p&lt;0.001), triglycerides \u22652 mmol\/L (OR 2.6 [95% CI 1.3\u20135.4] P&lt;0.01) and increase in BMI category (OR 1.8 [95% CI 1.2\u20132.8] p&lt;0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lipohypertrophy is a prevalent feature of fat redistribution among HIV patients on treatment. Risk factors for LH include male gender, dyslipidemia and overweight. Glucose impairment and bone disorders are also common. A multidisciplinary approach is important to identify and promptly address these disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Acknowledgments<\/jats:title><jats:p>The \u201cGroupe Lipo &amp; Metabolism\u201d team.<\/jats:p><\/jats:sec>","DOI":"10.7448\/ias.17.4.19559","type":"journal-article","created":{"date-parts":[[2014,11,3]],"date-time":"2014-11-03T08:30:34Z","timestamp":1415003434000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Lipohypertrophy and metabolic disorders in HIV patients on antiretroviral therapy: a systematic multidisciplinary clinical approach"],"prefix":"10.1002","volume":"17","author":[{"given":"Delphine","family":"Sculier","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Toutous\u2010Trellu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Verolet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Matthes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanh","family":"Lecompte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Calmy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,2]]},"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.7448%2FIAS.17.4.19559","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.7448\/IAS.17.4.19559","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T17:10:32Z","timestamp":1695575432000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.7448\/IAS.17.4.19559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11]]},"references-count":0,"journal-issue":{"issue":"4S3","published-print":{"date-parts":[[2014,11]]}},"alternative-id":["10.7448\/IAS.17.4.19559"],"URL":"https:\/\/doi.org\/10.7448\/ias.17.4.19559","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"type":"print","value":"1758-2652"},{"type":"electronic","value":"1758-2652"}],"subject":[],"published":{"date-parts":[[2014,11]]},"assertion":[{"value":"2014-11-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"19559"}}