Ultrazvučno praćenje lipoatrofije u bolesnika zaraženih HIV-om liječenih antiretrovirusnim lijekovima

doctoral thesis

• Title (english): US assessment of lipoatrophy in HIV-infected patients taking antiretroviral therapy
• Author: Ana Šoštarić Zadro; VIAF: 305792062
• Mentor: Josip Begovac (mentor)
• Mentor: Klaudija Višković (komentor)
• Committee member: Adriana Vince (predsjednik povjerenstva)
• Committee member: Boris Brkljačić (član povjerenstva)
• Committee member: Zoran Brnić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2020-07-02, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology
• Universal decimal classification (UDC): 615 - Pharmacology. Therapeutics. Toxicology

Abstract

Cilj je ovog istraživanja okarakterizirati i usporediti promjene potkožnog masnog tkiva na licu, nadlaktici i potkoljenici u skupini HIV-om zaraženih osoba koje uzimaju antiretrovirusne lijekove (ARL). Radi se o prospektivnoj longitudinalnoj studiji u koju je bilo uključeno 77 ispitanika koji su odabrani iz inicijalne kohorte koja je evaluirana 2007. i 2008. godine. Istraživali smo reverzibilnost lipoatrofije mjerene ultrazvukom (UZV) u razdoblju od najmanje pet godina i čimbenike povezane s tom reverzibilnošću. Kod svih 46 bolesnika koji su uzimali stavudin, on je zamijenjen nekom drugom kombinacijom lijekova. Od 58 bolesnika koji su uzimali zidovudin, 16 (28 %) je uzimalo kombinacije temeljene na zidovudinu kod kontrolnog mjerenja. Dokazan je porast potkožne masti na licu (p < 0.001), dok na nadlaktici i potkoljenici nije bilo porasta. Osobe koji su bili pušači i slabo su se pridržavale mediteranske dijete imale su tanje potkožno masno tkivo na licu kod kontrolnog mjerenja (p = 0.030), kao i manji porast potkožne masti na licu u usporedbi s ostalima (p = 0.040). Naše istraživanje upućuje na to da se blaži porast potkožne masti na licu podudara s prestankom uzimanja stavudina i manjim uzimanjem zidovudina. Stil života s nepridržavanjem mediteranske dijete i pušenjem bio je povezan s manjim porastom potkožne masti na licu.

Abstract (english)

The aim of this study is to characterize and compare changes in subcutaneous fat in the malar, brachial and crural region in a cohort of HIV-infected patients taking antiretroviral therapy (ART). This prospective longitudinal study included 77 patients who were selected from the initial cohort that was evaluated in 2007 and 2008. We examined reversibility of lipoatrophy measured by ultrasound (US) over an at least five-year period and factors related to its reversibility. All 46 patients who used stavudine switched from stavudine to another combination. Of 58 patients on zidovudine 16 (28%) were on a zidovudine based regiment at the second follow-up. There was evidence of subcutaneous fat increase in malar (p<0.001) and no increase in brachial and crural area. Patients who were smokers and had poor adherence to the Mediterranean diet had a thinner malar area at the follow up measurement (p=0.030) and a smaller increase in subcutaneous malar fat compared to others (p=0.040). Our study suggests that modest increase of subcutaneous fat in malar area coincided with stopping stavudine and fewer usages of zidovudine. Life style with non-adherence to the Mediterranean diet and smoking was associated with a smaller increase in subcutaneous malar fat.

• Keywords: lipoatrofija; HIV; antiretrovirusni lijekovi
• Keywords (english): lipoatrophy; HIV; antiretroviral therapy
• Language: croatian
• URN:NBN: urn:nbn:hr:105:900997
• Promotion: 2021
• Project: Number: 108-108011-0098; Title: Epidemiološka i klinička obilježja zaraze HIV-om u Hrvatskoj; Leader: Josip Begovac; Jurisdiction: Croatia; Funder: Ministarstvo znanosti, obrazovanja i športa; Funding stream: ZP
• Project: Number: IP-2014-09-4461; Title: Molekularna, epidemiolološka i klinička obilježja zaraze HIV-om u Hrvatskoj; Title: Molecular, epidemiological and clinical features of HIV infection in Croatia; Acronym: MEKHH/MECHC; Jurisdiction: Croatia; Funder: HRZZ; Funding stream: IP
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Catalog URL: https://katalog.nsk.hr/F/19IT7Y755V1NXQJPHCLYSQGPF6BLAPPF179HQ7FAXXMYBYGMV5-05543?func=find-e&request=Ultrazvu%C4%8Dno+pra%C4%87enje+lipoatrofije+u+bolesnika+zara%C5%BEenih+HIV-om+lije%C4%8Denih+antiretrovirusnim+lijekovima&find_scan_code=FIND_NAS&adjacent=N&local_base=MF_WEB&x=41&y=16&filter_code_1=WLN&filter_request_1=&filter_code_2=WYR&filter_request_2=&filter_code_3=WYR&filter_request_3=&filter_code_4=WFM&filter_request_4=
• Type of resource: Text
• Extent: 103 str.; 30 cm
• File origin: Born digital
• Access conditions: Open access
• Public note: Ključne riječi oblikovao urednik.
• Created on: 2021-03-05 10:39:24