Gender Response to HIV Therapy is Similar, Women Experience More Side
Effects, According to Emory University Study
In a study of men and women treated for HIV at an inner city U.S. clinic,
investigators from the Emory University Center for AIDS Research (CFAR)
found that although gender did not affect the response to HAART therapy
(highly active anti-retroviral therapy), women suffered significantly
more side effects. Results of the study will be presented Wednesday
at the 14th International AIDS Conference in Barcelona, Spain.
The retrospective study included
222 patients (74 women, 148 men) with HIV treated between May, 1996
and October, 2001 and followed for at least two years. Women in the
study were selected randomly from clinic records and matched with men
(1:2) by age, race, baseline CD4 count and hepatitis C (HCV) status.
Eighty-four percent of patients were African-American and 27% had advanced
AIDS (defined as a CD4 count <50 cells/L).
Patients were determined
to have successfully responded to HAART therapy if their HIV viral load
was undetectable at 24 months. After two years of HAART, 34/74 (45.9%)
of women and 72/148 (48.6%) men had an undetectable viral load. However,
women in the study had significantly higher rates of neurologic complications
(12.6% vs. 8.0%) and lipodystrophy (10.8% vs. 2.0%). Lipodystrophy is
a defect in fat metabolism that can result in a loss of subcutaneous
fat and/or an altered distribution of body fat.
The researchers also correlated
response to therapy with other variables, including the number of opportunistic
infections, changes in CD4 count, viral load, body mass index, or non-adherence
to therapy and determined that there was no significant difference between
men and women.
"Although previous limited
data have suggested that women have a lower initial viral load and a
more rapid response to HAART, our findings indicate that gender response
is similar given a comparable CD4 count," said Carlos del Rio, M.D.,
Emory's CFAR associate director for clinical science and international
research. "We intend to pursue further studies to confirm our findings
that women experience greater side effects."
The Emory research group
also included Jeffrey Lennox, M.D., Minh Nguyen, M.D., G. Sonia Nagy,
M.D., Isabel Hernandez, and Jeffrey Holtzberg.