Changes in Abdominal Fat Following Antiretroviral Therapy Initiation in HIV-infected Individuals Correlate with Waist Circumference and Self-Reported Changes

Citation: Bhagwat P, Ofotokun I,  McComsey GA, Brown TT, Moser C, Sugar CA, Currier JS. Changes in Abdominal Fat Following Antiretroviral Therapy Initiation in HIV-infected Individuals. Antivir Ther. 2017;22(7):577-586. doi: 10.3851/IMP3148. Epub 2017 Mar 1. PMID: 28248190. PMCID: PMC5610106. 

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We examined whether waist circumference (WC) and self-reported abdominal size changes can estimate visceral adipose tissue (VAT) changes for those initiating antiretroviral therapy (ART).


Prospectively collected data from ACTG A5257 and its metabolic substudy, A5260s, were used for this analysis. ART-naïve HIV-infected participants were randomized to one of three contemporary ART regimens. Changes in abdominal CT-measured VAT and total adipose tissue (TAT) and DXA-measured trunk fat were tested for association with WC changes (by Pearson correlation) and categories of self-reported abdominal size changes (by ANOVA) between entry and week 96. Linear models compared WC and self-reported changes.


The study population (N=328) was predominantly male (90%) and white non-Hispanic (44%) with a baseline median age of 36 years and BMI of 25 kg/m2. At week 96, median WC change was +2.8 cm. Of those reporting at week 96, 53% indicated "No Change/Lost", 39% "Gained Some/Somewhat Larger", and 8% "Gained A Lot/Much Larger" as their self-reported changes. Trunk fat, VAT, and TAT changes differed across self-reported groups (ANOVA p<0.0001 for all), and the group ordering was as expected. WC changes were strongly correlated with CT and DXA changes (trunk fat: ρ=0.72, p<0.0001; VAT: ρ=0.52, p<0.0001; TAT: ρ=0.62, p<0.0001). While WC changes explained a greater proportion of VAT, TAT, and trunk fat variation, self-reported changes remained a significant predictor after controlling for WC (p<0.05).


WC and self-reported abdominal changes each correlated directly with imaging-derived abdominal fat measures, and can be used as reliable, affordable tools for central adiposity assessment.

Antiviral Therapy, 2017, in press 



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