Lipodistrofia em pessoas vivendo com HIV / AIDS : fisiopatologia e tratamento

Antiretroviral therapy has modified AIDS from a lethal to chronic disease. However, adverse effects have arisen, among them, the syndrome of lipodystrophy, characterized by poor distribution of body fat and metabolic alterations. Lipodystrophy can be classified into acquired and genetic lipodystrophy. In addition, inflammation-related receptors that may be associated with lipodystrophy, among which the CCR5 gene stands out. There is no treatment for lipodystrophy, but the literature describes that physical exercise helps in its control. Thus, to evaluate genes associated with genetic lipodystrophy in people living with HIV / AIDS, aims to contribute to a previous diagnosis and, therefore, to contribute to the indicative of intervention with physical exercise to better coping / control of lipodystrophy and, consequently, greater longevity and quality of life. The study aimed to verify possible associations between genetic polymorphisms in the susceptibility of lipodystrophy and the impact of physical exercise as non - drug treatment. With the results we observed that the prevalence of lipodystrophy was 59.70%, being 37.80% lipoatrophy, 30.40% lipohypertrophy and 31.80% mixed lipodystrophy. The highest incidence of lipodystrophy occurs in men (64.90%), with a prominence in sedentary individuals (64.00%). No significant association was found between CCR5Δ32. However, in male homozygous individuals the male sex was more susceptible to the development of lipodystrophy (OR 1.78 (1.04 - 3.04), p = 0.0350). Regarding the treatment, individuals with lipodystrophy, when submitted 12 weeks of strength training, had an increase in CD4 + T lymphocytes, reduction in glycemia, total cholesterol, triglycerides and an increase in the HDL-cholesterol fraction. In addition, training significantly increased bone density in all regions measured; (3.28%, p = 0.012), femoral head (8.45%, p = 0.044) and distal 1/3 of the radius (5.41%, p = 0.035). In this way, the results suggest strength training, can be used to control lipodystrophy, especially in men, who present a higher incidence and appear to be more susceptible.