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High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in Rwanda.

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dc.contributor Médecins Sans Frontières, Kimihurura, Kacyiru, 1361 Kigali, Rwanda. jvgrie@yahoo.com <jvgrie@yahoo.com>
dc.creator van Griensven, J
dc.creator De Naeyer, L
dc.creator Mushi, T
dc.creator Ubarijoro, S
dc.creator Gashumba, D
dc.creator Gazille, C
dc.creator Zachariah, R
dc.date 2007-08
dc.date.accessioned 2017-01-31T07:09:28Z
dc.date.available 2017-01-31T07:09:28Z
dc.identifier High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in Rwanda. 2007, 101 (8):793-8 Trans. R. Soc. Trop. Med. Hyg.
dc.identifier 0035-9203
dc.identifier 17467756
dc.identifier 10.1016/j.trstmh.2007.02.020
dc.identifier http://hdl.handle.net/10144/17679
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/17679
dc.identifier Transactions of the Royal Society of Tropical Medicine and Hygiene
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/17679
dc.description This study was conducted among individuals placed on WHO-recommended first-line antiretroviral therapy (ART) at two urban health centres in Kigali, Rwanda, in order to determine (a) the overall prevalence of lipodystrophy and (b) the risk factors for lipoatropy. Consecutive individuals on ART for >1 year were systematically subjected to a standardised case definition-based questionnaire and clinical assessment. Of a total of 409 individuals, 370 (90%) were on an ART regimen containing stavudine (d4T), whilst the rest were receiving a zidovudine (AZT)-containing regimen. Lipodystrophy was apparent in 140 individuals (34%), of whom 40 (9.8%) had isolated lipoatrophy, 20 (4.9%) had isolated lipohypertrophy and 80 (19.6%) had mixed patterns. Fifty-six percent of patients reported the effects as disturbing. The prevalence of lipoatrophy was more than three times higher when taking d4T compared with AZT-containing regimens (31.4% vs. 10.3%). Being female, d4T-based ART, baseline body mass index >or=25 kg/m(2) or baseline CD4 count >or=150 cells/microl and increasing duration of ART were all significantly associated with lipoatrophy. Lipoatrophy appears to be an important long-term complication of WHO-recommended first-line ART regimens. These data highlight the urgent need for access to more affordable and less toxic ART regimens in resource-limited settings.
dc.language en
dc.publisher Elsevier
dc.relation http://www.sciencedirect.com/science/journal/00359203
dc.rights Archived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.asp
dc.title High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in Rwanda.


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