?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.relation=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F8804%2F&rft.title=Body+habitus+changes%2C+metabolic+abnormalities%2C+and+subclinical+coronary+atherosclerosis+associated+with+long-term+antiretroviral+therapy&rft.creator=Calhoun%2C+Bridget+Colleen&rft.description=The+public+health+significance+of+this+work+reflects+the+HIV%2FAIDS+epidemic+and+growing+concerns+of+long-term+consequences+of+antiretroviral+therapy.+The+advent+of+highly+active+antiretroviral+therapy+(HAART)+has+greatly+improved+survival+among+those+with+HIV-infection.+As+a+corollary%2C+clinicians+and+researchers+face+a+range+of+long-term+complications+previously+of+little+importance+to+HIV-infected+patients.+HIV-associated+lipodystrophy+syndrome+(HIV-LS)+was+first+described+in+1998+and+involves+a+constellation+of+metabolic+and+morphologic+abnormalities.+Whereas+AIDS+wasting+syndrome+has+been+associated+with+immunosuppression+and+high+viral+burden%2C+HIV-LS+has+been+documented+with+immunocompetence+and+suppressed+viral+concentration.+Participants+of+the+local+site+of+the+Multicenter+AIDS+Cohort+Study+(MACS)+consented+to+photography+of+their+lipodystrophic+body+habitus+changes+during+routine+clinic+appointments.+The+compilation+of+these+photographs+was+used+to+develop+a+manual+for+clinicians+at+all+four+of+the+MACS+sites+in+order+to+accurately+document+the+syndrome%2C+and+permitted+initial+classification+of+HIV-LS+into+two+phenotypes.+A+third+phenotype+was+identified+following+a+preliminary+observation+of+lipoaccumulation+extending+bilaterally+and+symmetrically+from+the+breasts+laterally+into+the+axilla.+Additional+cases+were+subsequently+identified+within+the+MACS%3B+all+subjects+had+pre-existing+lipoaccumulation+of+at+least+one+other+anatomical+site.+It+was+speculated+as+to+whether+this+represented+a+previously+unrecognized+evolution+of+HIV-LS.+Our+next+project+involved+studying+the+health+related+quality+of+life+(HRQL)+of+men+with+HIV-LS.+We+found+HIV-LS+does+not+negatively+affect+HRQL+or+exacerbate+depressive+symptoms+above+and+beyond+the+diagnosis+of+HIV-infection.+The+metabolic+abnormalities+of+HIV-LS+include+insulin+resistance+and+dyslipidemia%2C+both+of+which+are+considered+pro-atherogenic+risks.+The+final+segment+of+this+project+involved+detecting+coronary+artery+calcification+via+electron+beam+computed+tomography+among+HIV-infected+men+treated+with+HAART.+In+this+male+population+with+well+controlled+HIV-infection%2C+chronic+use+of+HAART+did+not+impact+the+progression+of+subclinical+coronary+atherosclerosis.+In+contrast%2C+traditional+atherosclerosis+risk+factors+of+smoking+and+advancing+age+were+predictive+of+coronary+atherosclerosis.+HIV-infection+requires+life-long+combination+treatment.+Clinicians%2C+researchers+and+patients+recognize+dyslipidemia%2C+peripheral+lipoatrophy+and+central+lipohypertrophy+as+significant+consequences+of+this+combination+therapy%2C+and+hope+that+concerns+regarding+increasing+cardiac+risk+are+not+warranted.&rft.date=2009-01-29&rft.type=University+of+Pittsburgh+ETD&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.language=en&rft.identifier=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F8804%2F1%2Fbccalhoun2008.pdf&rft.identifier=++Calhoun%2C+Bridget+Colleen++(2009)+Body+habitus+changes%2C+metabolic+abnormalities%2C+and+subclinical+coronary+atherosclerosis+associated+with+long-term+antiretroviral+therapy.++Doctoral+Dissertation%2C+University+of+Pittsburgh.++++(Unpublished)++