The HIV Lipodystrophy Case Study Group developed a scoring system to identify patients with HIV lipodystrophy. The authors are from multiple institutions from around the world.
(2) age of the patient in years
(3) duration of HIV infection
(4) CDC category
(5) waist to hip circumference ratio
(6) HDL cholesterol (after 3 day regular diet, overnight fast, well hydrated)
(7) anion gap
(8) visceral to subcutaneous fat ratio (VAT to SAT) from CT scan at mid-L4 vertebral level
(9) trunk to limb fat ratio from DEXA scan
(10) percent fat in leg based on DEXA scan
age of the patient
<= 40 years of age
> 40 years of age
duration of HIV infection
<= 4 years
> 4 years
waist to hip circumference ratio
(ratio) * 29
HDL cholesterol in mmol/L
(HDL cholesterol) * (-14)
anion gap in mmol/L
(anion gap in mmol/L)
VAT to SAT ratio
0.45 - 0.830
0.831 - 1.59
trunk to limb fat ratio
(ratio) * 5
14.5 - 21.4%
8.8 - 14.49%
waist to hip circumference ratio =
= (circumference of waist in cm) / (circumference of hips in cm)
VAT to SAT ratio =
= (area of intra-abdominal visceral fat on CT scan in square cm) / (area of subcutaneous extra-abdominal fat on CT scan in square cm)
trunk to limb fat ratio =
= (trunk fat in kg) / (limb fat in kg)
total score =
= SUM(points for all 10 parameters) - 43
• minimum score: my estimate is around -44
• A score < 0 indicates no lipodystrophy is present.
• A score >= 0 indicates lipodystrophy is present.
• Using a cutoff >= 0 had a sensitivity of 79% and specificity of 80% (from Table 7, page 733).
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Purpose: To determine if an HIV infected patient has HIV lipodystrophy.
Specialty: Endocrinology, Clinical Laboratory, Infectious Diseases
Objective: clinical diagnosis, including family history for genetics, criteria for diagnosis, severity, prognosis, stage