Carr A, Puls R, Law M; Conference on Retroviruses and Opportunistic Infections; HIV Lipodystrophy Case Definition Study Group.

Abstr 10th Conf Retrovir Oppor Infect Feb 10 14 2003 Hynes Conv Cent Boston Mass USA Conf Retrovir Oppor Infect 10th 2003 Boston Mass. 2003 Feb 10-14; 10: abstract no. 731.

St Vincent's Hosp, Sydney, Australia

BACKGROUND: Patient (pt) and physician (phys) rating of lipodystrophy (LD) severity are commonly recorded in studies, but their overall validity is unknown. Furthermore, it is not known if one assessment is superior.METHODS: Patient and physician-rated regional and overall LD severity (HOPS scale: 0 for nil, +1 for mild, +2 for moderate, or +3 for severe lipoatrophy/fat accumulation in each of 8 sites: face, neck, dorso-cervical spine, arms, breasts, abdomen, buttocks, and legs) were compared with objective measures of LD (DEXA, CT, and LD Case Definition Score [derived from the 10 objective parameters in the HIV case definition]), and metabolic (lipid, glycaemic, and acid-base) parameters known to correlate significantly with LD severity, using data from 417 cases (at least 1 mod-sev LD feature) and 371 controls (no LD) recruited to the recently completed HIV LD Case Definition Study. The respective pt and physician correlation co-efficients (r values) for each comparison were then compared.RESULTS: Patient and physician r values were similar for each of 90 comparisons. The strongest objective correlations with overall LD severity were with the LD Case Definition scores (rPhys = 0.641; rPt = 0.620), whereas the strongest imaging correlations with overall LD severity were for trunk:limb fat ratios on DEXA were lower (rPhys = -0.488; rPt = -0.475). The hierarchy for r values for overall/regional LD severity was overall > leg > peripheral > abdominal > arm > buttock. Although the rPhys and rPt values were similar, rPhys values were greater for 66 of 90 comparisons.CONCLUSIONS: Patient and physician-rated severity of LD severity correlate variably with objective measures, with physician assessment performing slightly better. However, the best correlate of LD severity was the LD Case Definition Score, which has the additional advantage of being determined objectively. These data suggest that patient rating can be abandoned as a tool to measure LD severity, at least in cross-sectional studies. The Case Definition score may be a better marker of severity than either physician or patient assessment.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Cross-Sectional Studies
• HIV Infections
• HIV Seropositivity
• Humans
• Lipodystrophy
• Physical Examination
• Physicians
• Research Design

Other ID:

• GWAIDS0021748

UI: 102261372

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