PMID- 20073992
OWN - NLM
STAT- MEDLINE
DCOM- 20100421
LR  - 20131121
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 50
IP  - 4
DP  - 2010 Feb 15
TI  - Association between HLA-B*4001 and lipodystrophy among HIV-infected patients from 
      Thailand who received a stavudine-containing antiretroviral regimen.
PG  - 597-604
LID - 10.1086/650003 [doi]
AB  - BACKGROUND: Stavudine-containing antiretroviral regimens are widely used in 
      developing countries. Stavudine-associated lipodystrophy commonly occurs, without 
      a clear predictable pattern owing to the unknown interaction between stavudine 
      and the host, among patients who received this regimen. The aim of this study was 
      to determine the clinical risk factors and human leukocyte antigen (HLA) alleles 
      associated with stavudine-associated lipodystrophy. METHODS: A case-control, 
      cross-sectional study was conducted for HIV-infected patients receiving 
      stavudine-containing antiretroviral regimens. Clinical assessments for 
      lipodystrophy by physical examination, anthropometry, and dual-energy X-ray 
      absorptiometry were obtained. On the basis of their clinical assessment, the 
      patients were classified into 2 groups: the case group (moderated to severe 
      lipodystrophy) and the control group (absent to mild lipodystrophy). The clinical 
      characteristics and allelic distribution of HLA-A, HLA-B, HLA-C, HLA-DRB1, 
      HLA-DQB1, and HLA-DPB1 were compared between the case group and the control 
      group, to determine the possible association with stavudine-associated 
      lipodystrophy. RESULTS: There were 103 patients; 55 patients were in the case 
      group, and 48 patients were in the control group. By use of forward stepwise 
      logistic regression, the presence of HLA-B*4001 (odds ratio [OR], 14.05; 95% 
      confidence interval [CI], 2.57-76.59; P=.002) and a longer duration of stavudine 
      treatment (OR, 1.02; 95% CI, 1.00-1.04; P=.02) were significantly associated with 
      stavudine-associated lipodystrophy, whereas a higher body mass index during 
      treatment (OR, 0.73; 95% CI, 0.61-0.86; P<.001) was associated with a lower risk 
      for lipodystrophy. HLA-B*4001 has a high specificity (95.8%) and a positive 
      predictive value (88.9%) for lipodystrophy. CONCLUSIONS: HLA-B*4001 is a strong 
      genetic risk factor for stavudine-associated lipodystrophy in HIV-infected 
      patients in Thailand. HLA-B*4001 may be used as a genetic marker to predict which 
      patients will develop stavudine-associated lipodystrophy, to avoid or shorten the 
      duration of stavudine use. This finding needs to be confirmed in further 
      replication studies.
FAU - Wangsomboonsiri, Wittaya
AU  - Wangsomboonsiri W
AD  - Departments of Medicine, University of Tokyo, Tokyo, Japan.
FAU - Mahasirimongkol, Surakameth
AU  - Mahasirimongkol S
FAU - Chantarangsu, Soranun
AU  - Chantarangsu S
FAU - Kiertiburanakul, Sasisopin
AU  - Kiertiburanakul S
FAU - Charoenyingwattana, Angkana
AU  - Charoenyingwattana A
FAU - Komindr, Surat
AU  - Komindr S
FAU - Thongnak, Chupong
AU  - Thongnak C
FAU - Mushiroda, Taisei
AU  - Mushiroda T
FAU - Nakamura, Yusuke
AU  - Nakamura Y
FAU - Chantratita, Wasun
AU  - Chantratita W
FAU - Sungkanuparph, Somnuek
AU  - Sungkanuparph S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (HLA-B Antigens)
RN  - BO9LE4QFZF (Stavudine)
SB  - IM
MH  - Adult
MH  - Anti-Retroviral Agents/*therapeutic use
MH  - Body Composition
MH  - Case-Control Studies
MH  - Cross-Sectional Studies
MH  - Female
MH  - HIV Infections/*drug therapy/epidemiology/immunology
MH  - HLA-B Antigens/*genetics/immunology
MH  - Humans
MH  - Lipodystrophy/epidemiology/*virology
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Risk Factors
MH  - Sensitivity and Specificity
MH  - Stavudine/*therapeutic use
MH  - Thailand/epidemiology
EDAT- 2010/01/16 06:00
MHDA- 2010/04/22 06:00
CRDT- 2010/01/16 06:00
PHST- 2010/01/16 06:00 [entrez]
PHST- 2010/01/16 06:00 [pubmed]
PHST- 2010/04/22 06:00 [medline]
AID - 10.1086/650003 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2010 Feb 15;50(4):597-604. doi: 10.1086/650003.