Lipodystrophy among patients on antiretroviral therapy at Harare City Opportunistic Infections Clinics, 2010

Tsanzirayi, Bara Hilda (2013) Lipodystrophy among patients on antiretroviral therapy at Harare City Opportunistic Infections Clinics, 2010. UNSPECIFIED thesis, UNSPECIFIED.

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Objective: To determine factors associated with lipodystrophy among patients on anti-retroviral therapy (ART) at Harare City Opportunistic Infections Clinics Design: Unmatched 1:1 case control study Setting: Two ART initiating and referral hospitals belonging to Harare City Health Department in Zimbabwe Subjects: Patients aged 12 years and above on ART at Harare City health facilities for at least 18 months Main outcome measures: Type and severity of lipodystrophy, factors associated with lipodystrophy Results: Out of all participants females constituted 84.3% of cases and 71.9% of controls. The median duration on ART was 48 months (Q1=25; Q3=61) for cases and 35.5 months (Q1=25; Q3=46) for controls. Lipodystrophy affected the legs in 194 (92.38%) cases. The most common type in females was the mixed type (74.8%) and lipoatrophy (53.13%) in males. Of the cases 150 (71.43%) perceived their condition as severe. The median HIV Outpatients Survey (HOPS) scale for the legs and buttocks each was 3 (3; 3). When lipodystrophy developed 197 (93.81%) cases were on a stavudine based combination and 11 (5.24%) on a zidovudine based combination. iii Factors associated with lipodystrophy were a stavudine based regimen (OR=9.84; 95% CI 5.47-16.44), difference between first repeat and baseline CD4 above 400 (OR=5.18; 95% CI 1.95-13.78), age above 40 years (OR=2.47; 95% CI 1.46-4.29), duration after testing HIV positive greater than 4 years (OR=2.37; 95% CI 1.43-3.94), WHO stage at initiation above 2 (OR=2.17; 95% CI 1.29-3.66), female sex (OR=2.16; 95% CI 1.29-3.59) and a baseline CD4 below 100 (OR=2.16; 95% CI 1.29-3.59). A baseline BMI below 20 (OR=0.53; 95% CI 0.31-0.91) was protective. Conclusion: Stavudine based regimen was the most significant factor. Patients belonging to the high risk groups should not be initiated on stavudine whilst those already on stavudine

Item Type: Thesis (UNSPECIFIED)
Uncontrolled Keywords: lipoatrophy,Harare City,lipodystrophy,lipohypertrophy,mixed type,Zimbabwe
Divisions: Universities > State Universities > University of Zimbabwe
Depositing User: Mr. Edmore Sibanda
Date Deposited: 09 Jan 2016 23:32
Last Modified: 09 Jan 2016 23:32

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