Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

XIV International AIDS Conference

Abstracts WePeC6253-WePeC6256 143

WePeC6253 Validity of body image perception in women with
HIV.
G. Guaraldi1, G. Orlando1, R. Murri2, E. Orlandi1, R. Covezzi1, G. Nardini1,
B. Beghetto1, A. Bedini1, R. Esposito', A. Wu3. 1Universita di Modena, Clinica
Malattie Infettive, Via del Pozzo, 71, 41100, Modena, Italy; 2Universita Cattolica,
Roma, Italy; 3Johns Hopkins University, Baltimore, United States
Background: Tests are needed to study fat redistribution in HIV/AIDS. The aim of
this study was to assess the validity of tests of perceived body image and related
attitudes, originally designed for eating disorders, for use in HIV+ women.
Methods: Cross-sectional, observational study. Anthropometric measurements
(BMI, Waist-to-hip ratio (WHR)) and body CT provided objective evaluation of
lipodystrophy. Accuracy of body image perception was assessed using Distorting
Television Image Methods (DTIM) in which patients view televised images of their
body and are asked to alter the image to correspond to how they think they looked
(image accuracy). Attitudes about body image were measured using: the 1) Body
cathexis scale (BCS) to assess body satisfaction;2) Multidimensional body selfrelation questionnaire (MBSRQ): affective and cognitive aspects of body image
and 3) Body attitude test (BAT): subjective body experience and attitude towards
one's body.
Group comparisons were performed using the Kruskall-Wallis test
Results: Twenty patients (78%) met the definition for lipodystrophy, and 7 served
as controls.
Using DTIM, in the lipodystrophy group, frontal image accuracy on the horizontal
axis was 99.2 + 9.5% and on the vertical axis was 100.2 ~ 6.0%; in profile image
accuracy on the horizontal axis was 100.6 ~ 0.6% and on the vertical axis was
100.1 + 8.1%. Very similar results were seen for control patients and in an agegender-BMI matched HIV- historial control group (p=N.S.) However, there were
no statistically significant differences between groups in BCS, MBSRQ or BAT
Conclusions: Body size self-perception was highly accurate in HIV+ women with
fat redistribution. However, existing measures of attitudes about body image were
insensitive to body changes. For HIV research, self-report questionnaires seem
to be appropriate for describing body size, but new, specific tools are needed to
assess the impact of fat redistribution.
Presenting author: Giovanni Guaraldi, Clinica Malattie Infettive, Via del Pozzo,
71, 41100, Modena, Italy, Tel.: [phone], Fax: [phone], E-mail:
g.guaraldi @ unimo.it
WePeC6254 Increasing rate of cardiac procedures among
HIV-positive individuals on antiretroviral therapy
from 1993 - 2001
PK.A. Braitstein1, B. Yip1, J.S.G. Montaner1, A. Levy2, J. Joseph2, F.M. Kiely3,
M.V. O'Shaughnessy1, R.S. Hogg'. IBC Centre for Excellence in HIV/AIDS, 608
- 1081 Burrard St., Vancouver, BC, Canada; 2Centre for Health Evaluation and
Outcome Sciences, Vancouver, Canada; 3BC Cardiac Registries, Vancouver,
Canada
Objective: To determine the rate of cardiac procedures among persons infected
with HIV on antiretrovirals from 1993 - 2001.
Methods: Since 1991, antiretrovirals in British Columbia have been centrally distributed by the B.C. Centre for Excellence in HIV/AIDS. The B.C. Cardiac Registry
maintains information regarding all cardiac procedures in British Columbia. These
databases were linked to determine the number of cardiac procedures among
persons on antiretrovirals. Rates are expressed as cardiac procedures per 1000
active participants (i.e. actively on antiretrovirals) and were calculated from 01/93
to 11/01. Linear regression was used to assess slope (1997 - 2000).
Results: Of the 63 individuals in the Cardiac Registry who have also received
antiretrovirals, there were 97 events: 70 (72%) since 1999. There were 30 openheart surgeries (53% since 1999), 31 coronary angioplasties (58% since 1999),
and 36 diagnostic catheters (the Registry only began collecting this data in 1999).
After excluding the diagnostic catheters, procedures since 1999 still represent
56% of all cardiac procedures among HIV-positive individuals on antiretrovirals.
The event rates per 1000 active participants, per year, were - [1993: 0.70]; [1994:
2.35]; [1995: 3.37]; [1996: 1.65]; [1997: 0.34]; [1998: 1.57]; [1999: 3.54]; [2000:
6.18]; [2001: 4.23]. Linear regression found an increase of 1.95 procedures per
1000 active participants per year, p=0.013.

Presenting author: Paula Braitstein, 608 - 1081 Burrard St., Vancouver, BC,
Canada, Tel.: [phone] #63212, Fax: [phone], E-mail: paulab
@interchange.ubc.ca
WePeC6255 Factors associated to the impact of lipodystrophy
on quality of life in HIV-1-infected patients
J. Blanch1, A. Rousaud1, E. Martinez2, E. De Lazzari3, J.M. Peri1,
A. Milinkovic2, J.B. Perez-Cuevas2, J.L. Blanco2, J.M. Gatell2. 1Clinical Institute
of Psychiatry and Psychology, Hospital Clfnic Universitari, Clinical Institute of
Psychiatry and Psychology, Hospital Clfnic Universitari, Villarroel 170, 08036
Barcelona, Spain; 2Clinical Institute of Infectious Diseases and Immunology,
Hospital Clinic Universitari, Barcelona, Spain; 3 Epidemiology and Biostatistics
Unit, Hospital Clinic Universitari, Barcelona, Spain
Introduction: There appear to be several reasons for the impact of lipodystrophy
changes on the quality of life (QoL) of HIV-infected patients. Body changes may
stigmatise patients, producing erosion of self-image and self-esteem, problems in
social and sexual relations, and anxiety and depression. Few published studies to
date have assessed the impact of lipodystrophy on QoL in HIV-infected patients
using standardised questionnaires. The aim of this study was assess the factors
associated with a greater impact of lipodystrophy on QoL in these patients.
Methods: Consecutive HIV-1 infected outpatients who had been taking HAART
for more than one year and who fulfilled clinical criteria for lipodystrophy were
asked about the presence of lipodystrophic changes in several parts of the body
such as face, neck, arms, breast, abdomen, buttocks, and legs. They also completed a modified version of the Dermatology Life Quality Index (DLQI) to measure
the impact of body image changes in QoL.
Results: Of 84 included patients 65.5% referred that body changes had influenced dressing, 48.8% referred to feel ashamed due to body changes; 27.4%
referred problems in sexual life. Women, intravenous drug users, patients with
abdominal or breast lipoaccumulation, and patients suffering from more nonlipodystrophy-related side-effects showed greater impact due to body changes
on several domains of the DLQI. Using the score of the whole DLQI scale as
a dependent variable multivariate proportional odds model analysis showed that
non-lipodystrophy-related side-effects intensity (P = 0.662; 95%CI = 0.174 - 1.151;
p = 0.008) and suffering from lipodystrophic changes in the breast (P = 1.322;
95%CI = 0.370 - 1.371; p = 0.001) were associated with greater impairment of
psychosocial functioning.
Conclusion: The impact of lipodystrophy on QoL seems to be influenced by
patients' characteristics, non-lipodystrophy side-effects, and changes in certain
parts of the body.
Presenting author: Jordi Blanch, Clinical Institute of Psychiatry and Psychology, Hospital Clinic Universitari, Villarroel 170, 08036 Barcelona, Spain, Tel.:
[phone], Fax: [phone], E-mail: jblanch @ clinic.ub.es
WePeC6256 The lean body mass in HIV infected patients
G. Tsekes1, D. Paraskeva1, G. Douskas2, N. Mangafas1, M. Chini1, M. Boboli1,
D. Chalkiadaki1, E. Georgiou2 M.C. Lazanas. 'Red Cross Hospital, 44 Pythias
st, GR-11364, Athens, Greece; 2Hygias Melatron, Athens, Greece
Background: There are insufficient data regarding lean body mass changes during the course of HIV infection. This study was conducted in order to define possible lean changes in a group of HIV infected patients followed longitudinally.
Methods: The study population consisted of 59 HIV-1 infected patients (48 males,
11 females) aged 37.1~8.9 years. Whole body composition was determined by
DEXA (Hologic 4500); fat (FAT) and lean body mass (LBM) were evaluated for
whole body as well as regionally. Two body composition analyses were obtained
for each patient; the second measurement was done thirty months after the first.
Most patients at first assessment were on dual NRTI therapy, whereas 24 patients
at follow-up were receiving a protease inhibitor containing regimen. Statistical significance was set at 0.05.
Results: Mean BMI on first measurement was 24.34~3.51 kg/m2 and mean
CD4+ T-cell count was 369+185 /il. Twenty-five subjects on first measurement
and 30 subjects on second measurement were classified as AIDS patients
(CDC, 1993). Despite a significant decrease in Body Weight (BW1 =73.6~11.8 kg,
BW2=70.3+11.3 kg, p<0.001), patients preserved their LBM (LBM1=51.7+8.9
kg, LBM2=51.9~8.5 kg, p=0.57). The weight loss recorded was exclusively due
to Fat loss (FAT1=19.2~7.6 kg, FAT2=15.9-7.0 kg, p<0.001). Regarding regional
LBM analysis, Lean exhibited a significant increase in legs (legs LBM1=15.9~3.2
kg, legs LBM2=16.4+3.2 kg, p<0.01); in arms and trunk, however, Lean displayed insignificant changes (arms LBM1=6.0+1.6 kg, arms LBM2=6.11.4 kg,
p=0.06 - trunk LBM1=26.2~4.1 kg, trunk LBM2=26.0+4.0 kg, p=0.28). Results
did not differ between PI-treated and PI-naive patients.
Conclusions: Despite a significant decrease in body weight, exclusively due to
FAT loss, the HIV-1 infected patients studied preserved their Lean Body Mass.
No differences regarding BW, LBM and FAT changes were evident between PItreated and PI-naive patients.

Presenting author: George Tsekes, 44 Pythias st, GR-11364, Athens, Greece,
Tel.: [phone], Fax: [phone], E-mail: [email protected]

i

Rate of cardiovascular procedures among HIV-infected individuals on antiretroviral therapy
(1993-2001).
Conclusions: These preliminary data suggest a significantly increasing trend of
cardiac procedures among HIV-infected individuals receiving antiretroviral therapy.