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Genetic risk factor for lipodystrophy identified
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Patients with HIV whose genetic makeup includes the HLA allele HLA-B*4001 may be at an increased risk to develop lipodystrophy during treatment for HIV.
Researchers from Thailand concluded that HLA-B*4001 was a "strong genetic risk factor for stavudine-associated lipodystrophy" among patients with HIV. They said doctors could now use HLA-B*4001 as a genetic marker to predict which patients may develop lipodystrophy during treatment with stavudine. They recommended that, if necessary, treatment with stavudine could be avoided or reduced among this patient population.
The researchers noted that antiretroviral regimens used to treat patients with HIV in developing countries often contain stavudine. They also noted that stavudine-associated lipodystrophy is common among patients receiving such treatments. However, doctors have had difficulty determining which patients may be most at-risk for lipodystrophy.
To better understand the association between genetic factors, stavudine and the risk for lipodystrophy, the Thai researchers recruited 103 patients with HIV who were being treated with stavudine-containing antiretroviral regimens. Clinical assessments for lipodystrophy by physical examination, anthropometry and dual-energy X-ray absorptiometry were obtained for all patients in the study.
On the basis of their clinical assessment, the patients were classified into two groups. The case group (n=48) included those with moderated to severe lipodystrophy (n=55); the control group comprised patients with mild lipodystrophy or no signs of lipodystrophy.
The researchers then compared the clinical characteristics and allelic distribution of HLA-A, HLA-B, HLA-C, HLA-DRB1, HLA-DQB1 and HLA-DPB1 between the two groups of patients. The presence of HLA-B*4001 and a longer duration of stavudine treatment were significantly associated with stavudine-associated lipodystrophy, according to the results. In contrast, a higher body mass index during treatment was associated with a lower risk for lipodystrophy.
Sungkanuparph S, et al. Clin Infect Dis. 2010; 50:597-604.