Article

Quality of Life Research

, Volume 14, Issue 4, pp 981-990

First online:

The relationship between lipodystrophy-associated body changes and measures of quality of life and mental health for HIV-positive adults

  • Robert BurgoyneAffiliated withToronto General HospitalDepartment of Psychiatry, University of TorontoToronto General Hospital Immunodeficiency Clinic Email author 
  • , Evan CollinsAffiliated withToronto General HospitalDepartment of Psychiatry, University of Toronto
  • , Cheryl WagnerAffiliated withHIV primary care physician
  • , Susan AbbeyAffiliated withToronto General HospitalDepartment of Psychiatry, University of Toronto
  • , Mark HalmanAffiliated withDepartment of Psychiatry, University of TorontoSt. Michael’s Hospital
  • , Margaret NurAffiliated withToronto General Hospital
  • , Sharon WalmsleyAffiliated withToronto General HospitalDepartment of Medicine, University of Toronto

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Abstract

Objectives:To investigate the relationship between lipodystrophy-specific symptom severity and wellbeing. Methods:HIV-positive adult patients with body fat redistribution (lipodystrophy syndrome) associated with antiretroviral therapy reported their total non-lipodystrophy symptoms and side effects and completed measures assessing body fat changes (yielding Atrophy, Hypertrophy and Total Lipodystrophy scores), mental health and quality of life. Effects of total symptom complex and lipodystrophy severity on quality of life and mental health were analyzed using Spearman’s rho correlations. Logistic regression analyses were utilized to determine the relative-odds of depression produced by overall symptom count and lipodystrophy score increments. Results:Mean ratings for Hypertrophy and Atrophy corresponded to ‘very mild’ and ‘mild’ degrees of severity, respectively. The total symptom complex was associated with ratings for most of the mental health and quality of life measures. Patient-perceived body image scores were the sole study variable responsive to lipodystrophy severity ratings. In comparison to reference norms, a pronounced degree of body image impairment was evident. Conclusion: Although responsive to the total symptom profile, psychosocial measures typically utilized for evaluating quality of life and mental health status in HIV disease lacked sensitivity and specificity for measuring the consequences of lipodystrophy-associated fat distribution changes alone. Lipodystrophy severity did impact negatively on body image.

Keywords

Body image HIV Lipodystrophy Mental health Quality of life