HIGH VISCERAL ADIPOSITY INDEX (VAI) SCORE BEFORE AND AFTER TREATMENT IN YOUNGH HIV-POSITIVE PATIENTS

Abstract

The new therapies in HIV-positive patients are extremely effective in terms of immunological response. In western countries the mortality rate was reduced by 100% from 1984 to the current 8.8%. HIV people are now patients with a chronic disease characterized by also metabolic disorders. Long term virus alterations and treatment sideeffects induced lipid disorders, in particular hypercholesterolemia and hypertriglyceridemia. To assess cardiovascular risk (CVR) in HIV patients. From April 2012 to January 2013 we evaluated 20 HIV-positive naive patients, no HBV-HCV coinfected (19 males, age range 21-42 years, mean 31.8 + 4.8, BMI 23.5 + 3.8). Before and after inhibitor proteases (IP) treatment we evaluated weight, height, waist circumference, BMI, blood pressure, triglycerides, total, HDL and LDL cholesterol and glycemia. Visceral Adiposity Index (VAI) was also evaluated in order to assess CVR. All results refer to comparison between before and after 6 mm IP-treatment. At present 10 (50%) and 8 (40%) patients completed 6 and 2 mm of follow-up, respectively; the remaining 2 (10%) were lost to the follow-up. In all 10 patients that completed 6 mm of IP-treatment, total (154.6 + 37.2 vs 186.3 + 55.7; p=0.056), LDL cholesterol (95.6 + 29 vs 106.8 + 33.9; p=0.146), and triglycerides (107.3 + 42.6 vs 154.4 + 87.2; p=0.101) levels were not significantly increased. On the contrary, HDL cholesterol levels (41.8 + 8.5 vs 48.8 + 12.1; p=0.022) were significantly increased. BMI (23.7 + 3.6 vs 24.9 + 3.4; p=0.033) and waist circumference (84.5 + 5.5 vs 89.4 + 7.8; p=0.003) were significantly increased. Before IPtreatment, VAI score, adjusted for sex and age, showed abnormal high values in 8 of 10 patients. The remaining 2 patients had normal VAI score. At 6 m follow-up, VAI score persisted high in all 8 patients, with a worsening in 7 out 8 whereas, in the remaining 2 persisted a normal VAI score. Glycemia and blood pressure were in the normal range before and after 6 m IP-treatment. Our data confirm the alterations of lipidic profile in patients and suggests an increase CVR in treated and untreated with high VAI score despite young age. Furthermore, our study suggests VAI, among the most common indexes of adiposity assessment, is a very useful tool well mirroring “adipose tissue dysfunction” in HIV.