Although treatment experienced HIV-positive men and women had slightly greater gains in trunk fat after switching to a new regimen containing Prezista (darunavir), they also reported increased satisfaction with their bodies. These data were published in the July issue of AIDS Patient Care and STDs.

Of all of the side effects to HIV medication, body shape changes—both the loss of body fat in the face and limbs and gains of body fat in the trunk and other areas—are among the most distressing to people living with HIV. In fact, body shape changes have been identified as an independent cause of adherence problems in people taking antiretroviral (ARV) therapy.

Though body shape changes are less of a risk with the drugs that are more commonly used today, they do still occur in some people. This is particularly true in people who are heavily treatment experienced, who must sometimes combine the newer ARV drugs with older medication.

To determine the impact of Prezista on body shape changes and people’s perception of their bodies, Judith Currier, MD, from the University of California in Los Angeles, and her colleagues examined data from a large study of Norvir (ritonavir)–boosted Prezista in a diverse group of treatment-experienced people. The study, called GRACE, was the first that was specifically designed to compare the safety and effectiveness of an ARV medication between men and women and between white and black study participants.

In this particular analysis, Currier and her colleagues measured changes in trunk over time and also surveyed the GRACE study participants about their perceptions of their bodies and their satisfaction with their appearance. In all, 287 HIV-positive women and 142 HIV-positive men were examined for this analysis, all of whom received at least one dose of Prezista. In general, women in the study had less severe HIV disease progression at the study’s start.

Currier’s team found that although the participants gained weight and their waist size increased during the course of the study—by 2.5 centimeters (cm) in women and 1.3 cm in men—the participants nevertheless reported greater body satisfaction by the end of the study. In women, those who reported being either “satisfied” or “very satisfied” with their body appearance increased from 42 percent to 58 percent over the course of the study. In men, those “satisfied” or “very satisfied” increased from 56 percent to 63 percent.

Given the discrepancy between people’s actual body shape changes and their reported satisfaction with their bodies, the authors are calling for further study. First, the authors suggest that additional exploration is needed to better understand the reasons behind the body shape changes. Second, they urge that we need a better and more thorough understanding about how people perceive their bodies and how this may affect adherence.