HIV Infections Clinical Trial
Official title:
Fat Redistribution and Metabolic Change in HIV Infection (FRAM)
The purpose of this study is to collect data on the body's breakdown of sugar and fat in HIV infected adults. Data from this study will make clearer the roles of HIV infection and anti-HIV drugs in the development of diabetes, heart disease, and fat redistribution in HIV infected adults.
Changes in the amount of fat and how that fat was distributed were reported after the
introduction of antiretroviral therapy (ART) for HIV infected patients. Increases in
diabetes, heart disease, and blood levels of glucose and fats have also been reported.
However, the cause for these changes is still unclear, in part because clinical measures
have not been consistent between different trials. The contribution of age, duration of HIV
infection, duration and types of ART, and body weight on metabolic changes need to be
defined, and the relationship between metabolic disturbances and body composition changes
has also not been established. The purpose of this study is to examine HIV infected adults
and use objective measurements of fat to determine metabolic changes in this population,
their causes, and possible associations with other observed changes. Data from this study
will help guide future treatment plans for HIV infected people to help prevent or lessen the
risk for diabetes and cardiovascular disease.
There are 2 parts to this study. Part 1 will examine fat redistribution; there will be 2
groups in Part 1. Group 1 participants will be HIV infected adults recruited from specific
HIV clinics. Group 2 participants will be HIV uninfected adults currently enrolled in the
Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants will undergo
hands-over-head-to-toe wide-slice magnetic resonance imaging (MRI) and dual energy x-ray
absorptiometry (DEXA). Imaging measurements will be compared to anthropometric measurements
to determine whether anthropometric measurements can accurately quantify fat redistribution.
Participants will be asked to self-report fat distribution abnormalities, and this
self-reporting will be evaluated for accuracy as compared to the quantitative measures of
regional fat distribution. Blood collection will also occur to determine the possible
association of body composition changes with the types of ART a participant may have taken
or currently be taking.
Part 2 of this study will examine cardiovascular disease and factors for its development;
there will be 2 groups in Part 2. Group 1 participants will be HIV infected adults recruited
from specific HIV clinics. Group 2 participants will be HIV uninfected adults currently
enrolled in the CARDIA study. All participants will be assessed for blood pressure, family
history, lifestyle habits, and regional fat volumes by MRI and DEXA. Blood collection will
occur to test for glucose and lipids (traditional metabolic risk factors) and C-reactive
protein (CRP) and cytokines (novel inflammatory risk factors). Participants will also
undergo a carotid intimal medial thickness (IMT) measurement by ultrasound to determine the
prevalence of atherosclerosis in this population and associated contributing factors.
For Part 2, there will be a minimum of 2 visits. At both visits, fasting blood collection
will occur. A physical exam and self-reporting of lifestyle habits, and completion of
questionnaires about smoking, alcohol use, and medical and family history will occur at the
first visit.
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Observational Model: Defined Population, Time Perspective: Longitudinal
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