Hiv-associated Lipodystrophy In Physically Active Versus Inactive Men Living With Hiv

HIV-associated lipodystrophy refers to changes in body fat distribution that may impact the health among men living with HIV (MLHIV). One objective method of assessing lipodystrophy is through the fat mass ratio (FMR). Exercise is considered one of the cornerstones in managing body composition. However, comparisons of the FMR between MLHIV with different physical training status are lacking. PURPOSE: To compare the FMR between physically active and inactive MLHIV and healthy men. METHODS: In this retrospective cross-sectional study, the FMR and relative fat percentages of MLHIV on combined antiretroviral therapy (cART) participating in a supervised physical exercise program for at least 12 months (HIV-ACTIVE; n = 19, 52 ± 7 y, 24 ± 4 kg.m-2) were compared to those of MLHIV on cART and inactive for at least 12 months (HIV-INACTIVE; n = 19, 51 ± 7 y, 26 ± 3 kg.m-2) and HIV-uninfected men (CTL; n = 19, 51 ± 8 y, 26 ± 3 kg.m-2). HIV-ACTIVE group attended a supervised exercise program consisting of 3 sessions per week, each composed of 60 min of aerobic, strength and flexibility exercises with moderate intensity. FMR was calculated as the ratio between the percentage of fat in the trunk and the lower limbs obtained by DXA. RESULTS: HIV-INACTIVE showed a greater FMR (1.9 ± 0.5 vs. 1.5 ± 0.6 %; P = 0.02) and trunk fat percentage (33.1 ± 8.8 vs. 25.1 ± 10.1; P = 0.02) than the HIV-ACTIVE, with no difference between them in lower limbs fat percentage (HIV-INACTIVE: 17.4 ± 4.1 vs HIV-ACTIVE: 17.7 ± 5.8 %; P = 0.98). CTL group showed a lower FMR (1.2 ± 0.2; P < 0.02) and greater lower limbs fat percentage (24.7 ± 4.7 %; P < 0.001) than HIV-INACTIVE and HIV-ACTIVE, as well as a greater total fat percentage than HIV-ACTIVE (27.3 ± 6.2 vs. 21.8 ± 6.9 %; P = 0.02). CONCLUSION: Exercise seems to attenuate lipodystrophy by reducing trunk fat percentage with no changes in lower limbs fat mass. FMR and total fat percentage should not be used alone as markers of exercise-induced changes in lipodystrophy.