CC BY 4.0 · Journal of Health and Allied Sciences NU 2024; 14(03): 315-320
DOI: 10.1055/s-0043-1775761
Review Article

Self-Reported Lipodystrophy and Self-Perception of Body Image in Adults with HIV

Lismeia R. Soares
1   Department of Nutrition, Clinical Nutrition Program, Universidade Federal do Rio de Janeiro, Macaé, Brazil
,
2   Department of Dermatology of Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
,
3   Department of Statistical Analysis, Centro Universitário FMABC, Santo André, Brazil
,
Glaucia Luciano da Veiga
4   Clinical Analysis Laboratory, Centro Universitário FMABC, Santo André, Brazil
,
Beatriz da Costa Aguiar Alves
4   Clinical Analysis Laboratory, Centro Universitário FMABC, Santo André, Brazil
,
Thaís Gascón
4   Clinical Analysis Laboratory, Centro Universitário FMABC, Santo André, Brazil
,
Fernando L.A. Fonseca
4   Clinical Analysis Laboratory, Centro Universitário FMABC, Santo André, Brazil
5   Pharmaceutical Science Department at Universidade Federal de São Paulo/UNIFESP, Diadema, Brazil
› Author Affiliations

Abstract

Introduction and Objectives Nutritional assessment in individuals infected with HIV-1 holds significance as it allows for indirect monitoring of physiological and morphological changes, identification of nutritional risks, and effective intervention to maintain or restore nutritional status. This, in turn, contributes to enhancing the quality of life for this population. This study aims to establish a connection between self-image perceptions and body composition, biochemical profiles, and the use of lipid-lowering medications among adults with HIV who are undergoing outpatient follow-up in São Paulo, Brazil.

Methods A retrospective cross-sectional study was conducted involving 231 adults, both on and off antiretroviral drugs. The study subjectively assessed two aspects: (1) alterations in the redistribution of body fat (referred to as self-reported lipodystrophy) and (2) self-perceptions of body image. These variables were subsequently correlated with the individuals' self-perceived body image.

Results The study included 67% (n = 154) men and 33% (n = 77) women, with 28.5% (n = 66) having been exposed to some form of protease inhibitor. Among the participants, 40% (n = 98) perceived alterations in the redistribution of body fat (lipodystrophy). Notable changes included fat loss in the face, arms, thighs, and buttocks (p = 0.004, 0.006, 0.001, and 0.001, respectively), along with increased waistlines (p = 0.001), prominent veins (p = 0.001), and the presence or increase of lipomas (p = 0.046).

Conclusion A positive correlation was observed between the use of lipid-lowering medications and self-perceptions of body image. In this study, anthropometric and biochemical parameters proved more effective in assessing changes in the distribution of body fat among people living with HIV/AIDS compared to the subjective self-reported method.

Authors' Contributions

L.R.S. and J.C. participated in the preparation of the research project and the collection, analysis, and discussion of the data, as well as the writing of the manuscript. L.V.A.S., G.L.V., and F.L.A.F. participated in the preparation of the research project and the analysis and discussion of the data, as well as the writing and editing of the final manuscript. G.L.V. contribution: read and reviewed the final version of the manuscript. T.G. and B.C.A.A. reviewed the final version of the article.


Ethical Approval

The study was approved by the Ethical Committee of Hospital de Clinicas, protocol number: 0221/07.


Informed Patient Consent

All patients signed an informed consent form.




Publication History

Article published online:
29 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Oranges CM, Schaefer KM, Haug M, Schaefer DJ. The impact of aesthetic surgery on body image and its implications for mental and physical health. Aesthet Surg J 2016; 36 (08) NP256-NP258
  • 2 Soares LR, Casseb JSDR, Chaba DCDS, Batista LO, Sousa LVA, Fonseca FLA. Self-reported lipodystrophy, nutritional, lipemic profile and its impact on the body image of HIV-1-infected persons, with and without antiretroviral therapy. AIDS Care 2020; 32 (10) 1317-1322
  • 3 Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr 2005; 56 (05) 303-307
  • 4 Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 1974; 32 (01) 77-97
  • 5 World Health Organization (WHO). Body mass index (BMI). The Global Health Observatory. 2023 . Accessed August 10, 2023 at: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/body-mass-index
  • 6 Cotton BP, Lohman MC, Brooks JM. et al. Prevalence of and factors related to prescription opioids, benzodiazepines, and hypnotics among medicare home health recipients. Home Healthc Now 2017; 35 (06) 304-313
  • 7 Bergman RN, Stefanovski D, Buchanan TA. et al. A better index of body adiposity. Obesity (Silver Spring) 2011; 19 (05) 1083-1089
  • 8 Valdez R. A simple model-based index of abdominal adiposity. J Clin Epidemiol 1991; 44 (09) 955-956
  • 9 Précoma DB, Oliveira GMM, Simão AF. et al. Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology - 2019. Arq Bras Cardiol 2019; 113 (04) 787-891 [published correction appears in Arq Bras Cardiol 2021 Apr;116(4):855]
  • 10 Dos Santos AP, Navarro AM, Schwingel A. et al. Lipodystrophy diagnosis in people living with HIV/AIDS: prediction and validation of sex-specific anthropometric models. BMC Public Health 2018; 18 (01) 806
  • 11 Silva EF, Lewi DS, Vedovato GM, Garcia VR, Tenore SB, Bassichetto KC. Nutritional and clinical status, and dietary patterns of people living with HIV/AIDS in ambulatory care in Sao Paulo, Brazil. Rev Bras Epidemiol 2010; 13 (04) 677-688
  • 12 Nayir T, Uskun E, Yürekli MV, Devran H, Çelik A, Okyay RA. Does body image affect quality of life?: A population based study. PLoS ONE 2016; 11 (09) e0163290
  • 13 Alencastro PR, Barcellos NT, Wolff FH. et al. People living with HIV on ART have accurate perception of lipodystrophy signs: a cross-sectional study. BMC Res Notes 2017; 10 (01) 40
  • 14 Teeraananchai S, Kerr SJ, Amin J, Ruxrungtham K, Law MG. Life expectancy of HIV-positive people after starting combination antiretroviral therapy: a meta-analysis. HIV Med 2017; 18 (04) 256-266
  • 15 Martins C, Coelho FMDC, Pinheiro RT. et al. People living with HIV/AIDS: body image and its important associations with mental health and BMI. Psychol Health Med 2020; 25 (08) 1020-1028
  • 16 da Cunha J, Maselli LM, Stern AC, Spada C, Bydlowski SP. Impact of antiretroviral therapy on lipid metabolism of human immunodeficiency virus-infected patients: Old and new drugs. World J Virol 2015; 4 (02) 56-77
  • 17 Abrahams Z, Levitt N, Lesosky M, Maartens G, Dave J. Changes in body fat distribution on dual-energy X-ray absorptiometry in Black South Africans starting first-line antiretroviral therapy. AIDS Patient Care STDS 2016; 30 (10) 455-462