HIV-positive Latino patients were the most likely and HIV-positive black patients were the least likely to have lipodystrophy—undesirable changes in body fat, cholesterol and blood sugar—after starting antiretroviral (ARV) therapy, according to a study published online November 22 in the Journal of Acquired Immune Deficiency Syndromes.

Racial and ethnic differences in body fat composition, cholesterol and blood sugar have been well documented in HIV-negative patients, with both black and Latino patients commonly suffering from higher rates of diabetes and unhealthy cholesterol levels than white patients. Less is known, however, about the impact of race and ethnicity on such metabolic problems and changes in body fat composition in HIV-positive patients.

To explore the potential differences, Cynthia Gibert, MD, MSc, from George Washington University in Washington, DC, and her colleagues conducted repeated body measurements and blood analysis on 398 HIV-positive patients starting ARV therapy for the first time. Forty-three of the patients were Latino, 243 were black and 112 were white.

Though overall rates of diabetes and decreased sensitivity to insulin were not high, Dr. Gibert’s team found that Latinos were nearly twice as likely as either black or white patients to develop these conditions. Both white and Latino patients were more likely than black patients to have increases in LDL cholesterol—the “bad” cholesterol—than black patients.

Gilbert’s group also reported that Latinos were the most likely, and blacks the least likely, to have accumulation of fat deep in the gut area and loss of fat in the limbs.

Though the authors concede that the number of Latinos in their study was low, their methods of analysis were stringent enough that the differences seen in the study were statistically significant, meaning that they were too great to have occurred by chance. Gibert’s team also notes that because the study enrolled patients several years ago, there was much higher use of drugs such as Zerit (stavudine) and Retrovir (zidovudine), two drugs especially linked to loss of limb fat, than is common today.