The retrospective study included 222 patients (74 women, 148 men) with HIV treated between May, 1996 and October, 2001 and followed for at least two years. Women in the study were selected randomly from clinic records and matched with men (1:2) by age, race, baseline CD4 count and hepatitis C (HCV) status. Eighty-four percent of patients were African-American and 27% had advanced AIDS (defined as a CD4 count <50 cells/L).
Patients were determined to have successfully responded to HAART therapy if their HIV viral load was undetectable at 24 months. After two years of HAART, 34/74 (45.9%) of women and 72/148 (48.6%) men had an undetectable viral load. However, women in the study had significantly higher rates of neurologic complications (12.6% vs. 8.0%) and lipodystrophy (10.8% vs. 2.0%). Lipodystrophy is a defect in fat metabolism that can result in a loss of subcutaneous fat and/or an altered distribution of body fat.
The researchers also correlated response to therapy with other variables, including the number of opportunistic infections, changes in CD4 count, viral load, body mass index, or non-adherence to therapy and determined that there was no significant difference between men and women.
"Although previous limited data have suggested that women have a lower initial viral load and a more rapid response to HAART, our findings indicate that gender response is similar given a comparable CD4 count," said Carlos del Rio, M.D., Emory's CFAR associate director for clinical science and international research. "We intend to pursue further studies to confirm our findings that women experience greater side effects."
The Emory research group also included Jeffrey Lennox, M.D., Minh Nguyen, M.D., G. Sonia Nagy, M.D., Isabel Hernandez, and Jeffrey Holtzberg.