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3rd International Workshop on Adverse Drug Reactions
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Cite as: Antivir Ther. 2001 6(Suppl 4):page number (abstract no. xx)
Example: Antivir Ther 2001 (Suppl 4):3 (abstract no. 1)
| Oral Presentations Abstracts 1 to 30, pages 3 through 21 |
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| 1 | INHIBITION OF CELLULAR GLUCOSE UPTAKE BY INDINAVIR Antiviral Therapy 2001 6(Supplement 4):3 (abstract no. 1) H Murata, P Hruz and M Mueckler Indinavir appears to be a relatively selective inhibitor of the Glut4 isoform. As the concentration of indinavir required to significantly inhibit insulin-stimulated glucose uptake in rat adipocytes is well within the physiological range achieved in therapy (<10 μM), we propose that direct inhibition of Glut4 contributes to the insulin resistance observed in patients receiving this drug. |
| 2 | INDINAVIR INDUCES ACUTE AND REVERSIBLE INSULIN RESISTANCE IN RATS Antiviral Therapy 2001 6(Supplement 4):3 (abstract no. 2) PW Hruz, H Murata, H Qiu and M Mueckler These data demonstrate that indinavir causes acute and reversible changes in whole body glucose homeostasis in rats and support the contribution of GLUT4 inhibition to the development of insulin resistance in patients treated with PIs. |
| 3 | THE HIV PROTEASE INHIBITOR INDINAVIR ACUTELY INHIBITS INSULIN-STIMULATED GLUCOSE DISPOSAL: A RANDOMIZED, PLACEBO-CONTROLLED STUDY Antiviral Therapy 2001 6(Supplement 4):4 (abstract no. 3) MA Noor, T Seneviratne, FT Aweeka, JC Lo, JM Schwarz, K Mulligan, M Schambelan and C Grunfeld A single dose of indinavir acutely decreases total and non-oxidative insulin-stimulated glucose disposal during a euglycemic, hyperinsulinemic clamp. Our data provide the first evidence of an acute effect of indinavir on glucose disposal in humans, consistent with the proposed mechanism that PI-induced insulin resistance is mediated by a direct blockade of Glut4 transporters. |
| 4 | IMPAIRED GLUCOSE TRANSPORT AND PHOSPHORYLATION IN SKELETAL MUSCLE ASSESSED BY [18F] FLUORODESOXY-GLUCOSE POSITRON EMISSION TOMOGRAPHY IN HIV-PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):4 (abstract no. 4) GMN Behrens, K Weber, A-R Boerner, H Hecker, J Ockenga, G Brabant, M Stoll and RE Schmidt This is the first report providing in vivo evidence that in HIV patients receiving HAART both reduced glucose uptake and impaired intracellular glucose phosphorylation contribute to insulin resistance. Our study provides evidence that skeletal muscle is the primary site of insulin resistance on HAART. |
| 5 | HEPATIC INSULIN RESISTANCE IN HIV-ASSOCIATED LIPODYSTROPHY SYNDROME Antiviral Therapy 2001 6(Supplement 4):5 (abstract no. 5) SB Haugaard1, 0 Andersen2, H Storgaard1, F Somnier3, J Iversen2 and S Madsbad1 The finding of a similar HGP in-between groups, in spite of increased fasting levels of insulin in HALS patients, strongly suggests hepatic insulin resistance in the latter group. However, the peripheral insulin resistance is at least equally important to the defective insulin action in HALS, in view of the impaired peripheral glucose disposal rate in such patients. The data did not indicate any effect on HGP by the duration of the therapy with NRTI or with PI. |
| 6 | BOTH INSULIN RESISTANCE AND RELATIVE β-CELL INSENSITIVITY ARE CHARACTERISTICS OF HIV-ASSOCIATED GLUCOSE INTOLERANCE Antiviral Therapy 2001 6(Supplement 4):5 (abstract no. 006) KE Yarasheski1, E Breda2, M Hoffman1, S Claxton1, J Schulte1, K Mondi1, P Tebas1, C Cobelle2 and WG Powderly1 HIV-associated glucose intolerance is characterized by: (a) insulin resistance (b) insufficient β-cell insulin secretion given the fasting and ivGTI glucose levels and the degree of insulin resistance (that is, relative insulin deficiency) (c) a greater exposure to antiretroviral medications, and (d) an impaired ability of the liver to extract insulin. |
| 7 | INCREASED RATES OF LIPOLYSIS AMONG HIV-INFECTED MEN WITH AND WITHOUT FAT REDISTRIBUTION Antiviral Therapy 2001 6(Supplement 4):6 (abstract no. 7) C Hadigan1, S Borgonha2, J Rabe1, V Young2 and S Grinspoon1 These data demonstrate increased rates of lipolysis and increased total FFA levels in association with fat redistribution in HIV-infected subjects and suggest that increased lipolysis contributes to insulin resistance in this patient population. |
| 8 | ACUTE INHIBITION OF LIPOLYSIS IMPROVES INSULIN SENSITIVITY IN PATIENTS WITH HIV LIPODYSTROPHY AND INSULIN RESISTANCE Antiviral Therapy 2001 6(Supplement 4):7 (abstract no. 8) C Radigan1, G Meininger1, J Rabe1, N Aliabadi1, J Breu 2 and S Grinspoon1 Acute inhibition of lipolysis and a reduction in FFA levels were associated with improved insulin sensitivity in patients with HIV lipodystrophy and insulin resistance. Long-term strategies to reduce FFA concentrations may be useful in the treatment of the metabolic disturbances associated with HIV lipodystrophy. |
| 9 | DIFFERENT LACTATE METABOLISM IN PATIENTS WITH AND WITHOUT HIV-ASSOCIATED LIPODYSTROPHY SYNDROME Antiviral Therapy 2001 6(Supplement 4):7 (abstract no. 9) O Andersen1, SB Haugaard2, U Andersen3, F Somnier4, S Madsbad2 and J Iversen1 The missing inverse correlation between total glucose disposal and s-lactate in patients with HALS, in contrast to such a finding in HIV patients without lipodystrophy, suggests a different lactate metabolism in cases versus controls. The similar oxidative glucose metabolism, found under various circumstances irrespectively of HALS, may be attributable to a sufficient capacity of oxidative metabolism by the mitochondrial pool. The notion that the duration of the NRTI therapy may influence the level of s-lactate in HIV-infected patients with or without lipodystrophy, is not supported by our data. |
| 10 | NEPHROTOXICITY IN PATIENTS RANDOMIZED TO ZIDOVUDINE/LAMIVUDINE COMBINED WITH EITHER INDINAVIR 800 MG THREE TIMES A DAY OR INDINAVIR/RITONAVIR 800/100 MG TWICE A DAY: 64-WEEK OUTCOME Antiviral Therapy 2001 6(Supplement 4):8 (abstract no. 10) M Boyd1,2, E Hassink1,3, F Cox3, J Tromp3, O van Ruler3, M Felderhof3, A Mahanontharit1, C Duncombe1,2, K Ruxrungtham1, M Stek4, J Lange3, D Cooper2, P Phanupak1 and P Reiss3 Nephrotoxicity was similar for both arms with female gender, lower BMI, and longer duration of therapy noted as risk factors. Monitoring renal function is appropriate for patients on indinavir regimens. Effective management of nephrotoxicity was seen in these patients with no permanent discontinuations, although limited treatment options undoubtedly influenced trial retention. |
| 11 | PATHOGENESIS OF DRUG HYPERSENSITIVITY REACTIONS Antiviral Therapy 2001 6(Supplement 4):9 (abstract no. 011) M Pirmohamed [I]n summary, the pathogenesis of drug hypersensitivity reactions is complex and multi-factorial, and still not completely understood. Further research is needed not only to identify the mechanisms of drug hypersensitivity, but also the reasons why such reactions are more common in HIV-positive individuals. An understanding of the mechanisms is essential in order to develop evidence-based avenues to predict and prevent the occurrence of these potentially life-threatening adverse drug reactions. |
| 12 | BONE HISTOMORPHOMETRY IN HIV-INFECTED MEN Antiviral Therapy 2001 6(Supplement 4):9 (abstract no. 12) K Mondy, S Claxton, M Hoffman, K Yaraheski, W Powderly and P Tebas Diverse forms of osteoporosis may be seen in ART-experienced patients, suggesting that multiple mechanisms may underlie the pathogenesis of osteoporosis in HIV-infected individuals. Although the sample size was small, there was no obvious correlation between type and duration of ART and pattern of osteoporosis. Further longitudinal studies of bone histomorphometry in HIV-infected patients are warranted. |
| 13 | CHANGES IN BODY FAT DISTRIBUTION ARE DETECTABLE IN HIV-INFECTED CHILDREN TREATED WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY EVEN IN THE ABSENCE OF CLINICAL EVIDENCE OF LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):10 (abstract no. 13) A Vigano1, D Bricalle2, N Sala2, P Manzoni1, A Vanzulle3, G Chiumello1, B di Natale2 and P Brambilla1 Increased central fat and peripheral lipoatrophy are distinctive features of all HAART-treated children. Changes in body fat composition are detectable by DXA even in the absence of signs of LD. Only LD-positive show true central obesity. |
| 14 | PROSPECTIVE, 48-WEEK, INTENSIVE METABOLIC AND BODY COMPOSITION STUDY OF AMPRENAVIR-BASED THERAPY (COL30309) Antiviral Therapy 2001 6(Supplement 4):11 (abstract no. 14) MP Dubé1, D Qian2, HE Melançon2, FR Sattler2, D Goodwin3, C Martinez2, V Williams3 and TA Buchanan2 Amprenavir-based therapy did not cause short-term insulin resistance. An increase in BMC occurred, suggesting this regimen may not have deleterious effects on bone metabolism. Insulin resistance appeared late following weight gain, particularly trunk fat, but loss of limb fat or facial lipoatrophy did not occur. Unlike the short-term insulin resistance reported with indinavir, these late changes appear to be related to increased adiposity rather than a direct drug effect. |
| 15 | ABDOMINAL CT-SCAN SUB-STUDY OF STUDY DPC006 Antiviral Therapy 2001 6(Supplement 4):11 (abstract no. 15) K Tashima1, JO Morales-Ramirer2, D Butcher3, CBarros Aguado4, SL Boyko5, LM Ploughman5 and DJ Manion5 In this post hoc assessment of fat redistribution measured by abdominal CT-scan significantly more subcutaneous fat loss was noted in subjects receiving indinavir plus zidovudine plus lamivudine than efavirenz plus zidovudine plus lamivudine; however, significant subcutaneous fat loss between scans was noted for all arms. Though no difference in median change in visceral fat was noted between or within arms, the 75th percentile for visceral lipo-accumulation was threefold higher for the indinavir plus zidovudine plus lamivudine arm compared with the two other arms. |
| 16 | HIGH PREVALENCE OF THYROID ABNORMALITIES IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):12 (abstract no. 16) JL Esnault, E Billaud, B Milpied, B Bonnet, A Murat, S Leautez and F Raffi According to the Framingham study, prevalence of hypothyroidism in the general population is 0.1% in men and 1% in women. In our study, prevalence of hypothyroidism was 7.9% in men and 8.6% in women, and more frequent in AIDS patients. There is a correlation between duration of PI use and level of FT4 addressing the issue of PIs retinoid like effect on thyroid function but also the role of HIV infection by itself. |
| 17 | RISK FACTORS FOR HEPATOTOXICITY IN PATIENTS TREATED WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY: A COHORT STUDY Antiviral Therapy 2001 6(Supplement 4):13 (abstract no. 17) T Ouirino1, P Bonfanti1, I Faggion1, E Ricce2, L Valsecchi1, S Carradori1, L Pusterla1, P Fortuna1, L Timillero1, S Miccolis1, C Magnani1, S Landonio1, A Gabbuti1, R Cinelli1, F Parazzini2 and GM Vigevani1 Our study confirms that hepatotoxicity is a frequent adverse event in HAART therapy. Risk factors are the presence of hepatitis at baseline, while treatment with ritonavir involves a risk, which is at least twice as high as with other protease inhibitors. |
| 18 | INCREASED LONG-TERM MITOCHONDRIAL TOXICITY IN PYRIMIDINE NUCLEOSIDE COMBINATIONS Antiviral Therapy 2001 6(Supplement 4):13 (abstract no. 18) UA Walker, B Setzer and N Venhoff The in vitro data indicate possible additive or synergistic long-term mitochondrial toxicity of the pyrimidine nucleoside combinations. Mitochondrial damage due to some NRTI-concentrationslcombinations can worsen beyond 1 month of incubation. |
| 19 | QUANTIFICATION OF MITOCHONDRIAL DNA RELATIVE TO NUCLEAR DNA IN PERIPHERAL BLOOD MONONUCLEAR CELLS: VALIDATION OF AN ACCURATE DUPLEX ASSAY FOR USE IN PATIENTS UNDERGOING ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):14 (abstract no. 19) B van Gemen1, A de Ronde1, M Casula2, E Timmermans1, M van Dooren1, M Westrop1 I Dobbelaar1, M Bakker2, GJ Weverling2, J Lange2, J Goudsmit2 and P Reiss2 (1) The duplex assay we developed is able to quantify small changes in the amounts of mtDNA using nuclear DNA content as reference. (2) PBMC DNA can be used as input material to measure changes in mtDNA content in patients receiving treatment containing NRTIs. (3) Therapies containing standard dosages of NRTIs may result in reductions of mtDNA content detectable in PBMC using this duplex NASBA assay. Taken together these preliminary results indicate that this assay is suitable for monitoring mtDNA reductions resulting from different antiretroviral therapy regimens. |
| 20 | COMPETITIVE PCR-ANALYSIS OF SUBCUTANEOUS ADIPOSE TISSUE MITOCHONDRIAL DNA FROM INDIVIDUALS WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY -ASSOCIATED LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):15 (abstract no. 20) B Shiramizu, E Westgard, A Cossarizza, M Pinti and C Shikuma Quantitative decrease in the copy number of mtDNA per cell from subcutaneous adipose tissue was detected from HIV-infected individuals with lipodystrophy, which is consistent with mitochondrial toxicity. Additional analysis and standardization of mtDNA analysis of tissue-specific pathology are needed to determine if mtDNA toxicity is important in HAART-associated lipodystrophy. |
| 21 | INVESTIGATING LACTATE METABOLISM TO ESTIMATE MITOCHONDRIAL STATUS Antiviral Therapy 2001 6(Supplement 4):16 (abstract no. 21) P Leclercq, H Roth, A Bosseray and X Leverve These preliminary results indicate that there is a marked increase in endogenous lactate production, even in patients who have very moderate increase in lactatemia. Evaluation of the lactate turnover in patients with symptoms of NRTI toxicity reveals an increase in endogenous production an a respect of lactate clearance. These abnormalities are reversible after NRTI discontinuation. With this test (ELCT), we are able to measure lactate endogenous production. It is a tool easy to realize and so to repeat, allowing a monitoring of energetic metabolism in patients under HAART when a mitochondrial dysfunction is suspected. |
| 22 | ELEVATED IN VITRO TUMOUR NECROSIS FACTOR A RELEASE FROM ABDOMINAL SUBCUTANEOUS ADIPOSE TISSUE IN HIV-INFECTED SUBJECTS WITH LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):16 (abstract no. 22) JA Johnson, JB Albu, Q He, ES Engelson and DP Kotler (1) TNFα release from SAT is elevated in HIVL-positive subjects; (2) TNFα release is higher in SAT than in buffalo hump; (3) lactate and glycerol release from SAT are elevated in HIV-positive subjects, implying higher basal lipolysis; and (4) elevated lactate release from SAT is associated with NRTI therapy. |
| 23 | NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS: INHIBITION OF MITOCHONDRIAL DNA REPLICATION, BUT NO EFFECT ON ADIPOSITY IN AN OBESE MOUSE MODEL Antiviral Therapy 2001 6(Supplement 4):17 (abstract no. 023) OP Flint, S Wang, R Mulvey, L Kunselman and RA Parker Similar to a previous study, doses of stavudine 100-fold greater than the human dose of 1 mg/kg/day over 6 weeks induced a significant reduction in adipose tissue mtDNA, in the absence of changes in plasma indicators of fat metabolism. Importantly, there was no effect of stavudine on direct measurement of body fat mass by DEXA. These studies indicate that significant changes in mtDNA content can occur in fat tissue in the absence of lipoatrophy, suggesting that adipose tissue is relatively insensitive to moderate changes in mtDNA content. The findings do not support NRTI-induced depletion of mtDNA as mechanism for lipodystrophy in HIV-HAART. |
| 24 | DIFFERENTIAL IN VITRO EFFECTS OF INDINAVIR, NELFINAVIR AND AMPRENAVIR ON CELL DIFFERENTIATION, INSULIN SENSITIVITY AND APOPTOSIS IN AN ADAPTED ADIPOSE CELL MODEL: PREVENTIVE IMPACT OF ROSIGLITAZONE Antiviral Therapy 2001 6(Supplement 4):17 (abstract no. 24) M Caron, M Auclair, M Kornprobst and J Capeau Indinavir, nelfinavir and amprenavir affected several adipocyte key functions. Their effects differ in intensity in accordance with preliminary clinical data. This cell system is important to evaluate the effects of other PIs and/or nucleoside reverse transcriptase inhibitors on adipose cell function, thus giving additional information towards the choice of treatment regimens in the clinic. The prevention by rosiglitazone could represent a therapeutic possibility. |
| 25 | SYNERGISTIC ANTI-ADIPOGENIC EFFECTS OF HIV-1 PROTEASE INHIBITORS AND TNF-α IN 3T3-LL CELLS: ROLE OF ECM DEGRADING PRO TEASES Antiviral Therapy 2001 6(Supplement 4):18 (abstract no. 25) KC Agrawal, VF LaRussa and D Mondal These results indicate that the HIV-1 PIs may suppress adipogenesis by disrupting the concerted actions of host proteases that regulate ECM integrity required for initiation of differentiation. |
| 26 | EFFECTS OF GROWTH HORMONE ON HEPATIC LIPID AND CARBOHYDRATE METABOLISM IN HIV-INFECTED PATIENTS WITH FAT ACCUMULATION Antiviral Therapy 2001 6(Supplement 4):19 (abstract no. 26) JM Schwarz1,2, K Mulligan2, J Lee1, JC Lo2, M Wen1, MA Noor2, C Grunfeld2 and M Schambelan2 In HIV-infected subjects with fat accumulation, GH improved lipid profiles but worsened glucose homeostasis, under both fasting and hyperinsulinemic conditions. These results suggest that treatment with a pharmacological dose of GH is associated with hepatic, as well as peripheral insulin resistance that might lead to hyperglycemia. The combined implications of these positive and negative metabolic effects for cardiovascular disease risk remain unknown. |
| 27 | PROSPECTIVE STUDY OF HYPERLIPIDEMIA IN ANTIRETROVIRAL THERAPY-NAÏVE SUBJECTS TAKING ABACAVIR/COMBIVIR, COMBIVIR/NELFINAVIR, OR LAMIVUDINE/ STAVUDINE/NELFINAVIR (GSK PROTOCOL ESS40002) Antiviral Therapy 2001 6(Supplement 4):19 (abstract no. 27) P Kumar1, A Rodriguez-French2, M Thompson3, K Tashima4, V Williams5, P Wannamaker5, A Shachoy-Clark5 and K Pappa5 These preliminary results indicate that therapy with abacavir/Combivir has similar virological and immunological efficacy with a more favorable lipid profile as compared with PI-containing regimens. Gender-related trends continue to be explored. |
| 28 | COMPARISON OF THE METABOLIC DISORDERS AND CLINICAL LIPODYSTROPHY 48 WEEKS AFTER SWITCHING FROM HIGHLY ACTIVE ANTIRETROVIRAL THERAPY TO TRIZIVIR VERSUS CPNTINUED HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (TRIZAL:AZL30002) Antiviral Therapy 2001 6(Supplement 4):20 (abstract no. 28) A Lafeuillade1 on behalf of the TRIZAL Study Team, J-P Marner2 and A Cherer2 Fully suppressed patients switching to Trizivir maintained virological suppression but had improvements in lipids and clinical manifestations of lipodystrophy at 48 weeks. |
| 29 | A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED, COMPARATIVE STUDY ON THE EFFECTS OF METFORMIN OR GEMFIBROZIL IN LIPODYSTROPHIC HIV-1-INFECTED PATIENTS RECEIVING PROTEASE INHIBITORS Antiviral Therapy 2001 6(Supplement 4):21 (abstract no. 29) E Martinez1, P Domingo2, JB Pérez-Cuevas1, A Arroyo2, E Buira1, A Milinkovic1, M Ruiz1, G Vázquez2 and JM Gatell1 All three arms showed negligible effects not only for treating fat changes in HIV-1-infected patients with lipodystrophy, but also for treating associated metabolic abnormalities. The results of this study do not support the recommendation of either metformin or gemfibrozil to treat lipodystrophy in HIV-1-infected patients. |
| 30 | INCONSISTENT EFFECTS OF LIPID-LOWERING DRUGS IN THE MANAGEMENT OF HIV-ASSOCIATED DYSLIPIDEMIAS Antiviral Therapy 2001 6(Supplement 4):21 (abstract no. 30) F Visnegarwala, P Sajja, MC Rodriguez-Barraddas, M Maldonado, O Ong, K Kohil and AC White Jr. Though well tolerated in HIV dyslipidemia, the overall response to LLD was modest. Significant reduction in both TCHOL and triglycerides with fibrates may make them an attractive first choice for management of HIV-dyslipidemia. Only one-sixth of patients continuing protease inhibitors achieved the recommended TCHOL target. |
| Poster Presentations Abstracts 31 to 126, pages 25 through 83 |
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| 31 | CHANGES IN THE SPECTRUM OF DEATH CAUSES AMONG HIV-INFECTED PATIENTS DURING 1996-1999 Antiviral Therapy 2001 6(Supplement 4):25 (abstract no. 31) B Åkerlund1, A Karlsson2, C Håkangård3, K Koppel2 and L Morfeldt4 on behalf of The HivBivus Collaborative Group Following the introduction of effective ART there has been a great reduction in the rate of 'AIDS deaths'. However, in a substantial number of patients who died there was no severe immunodeficiency and in several of these cases ART may have caused or contributed to death. Accordingly, further surveillance with regard to drug associated fatal outcomes, as well as an increased frequency of post-mortem examination, are warranted. |
| 32 | OSTEOPOROSIS AND OSTEOPENIA IN TREATED AND NOT TREATED HIV-POSITIVE PATIENTS Antiviral Therapy 2001 6(Supplement 4):25 (abstract no. 32) C Amiel1, L Slama1, A Ostertag2, T NGuyen1, L Nai-Ighil1, S Gharakhanian1, E Lajeunie3, MC de Vernejoul2 and W Rozenbaum1 In HIV-infected population, osteoporosis/ osteopenia is frequent and BMD is decreased, even in untreated patients. Relationship between BMD and lipodystrophy or bone metabolism markers is currently assessed in our study as well as the possible difference in bone status according to the treatments. |
| 33 | SIGNIFICANT CORRELATION BETWEEN FAT DISTRIBUTION ABNORMALITIES, ELEVATED PLASMA LIPID LEVELS AND ASYMPTOMATIC HYPERLACTATEMIA: A POSSIBLE CONNECTION BETWEEN LIPODYSTROPHY AND MITOCHONDRIAL TOXICITY Antiviral Therapy 2001 6(Supplement 4):26 (abstract no. 33) A Antela, S Moreno, J Rubí, E Pallarés, M Pumares, JL Casado, MJ Pérez-Elías, F Dronda, A Moreno, L Moreno, ME Moreno and C Quereda A correlation was found between HL and FDA, suggesting a possible role for HL in asymptomatic patients receiving nucleoside analogues as a predictor of FDA. There is a correlation between HL and elevated plasma lipid levels, further suggesting a connection between MT and FDA. |
| 34 | [13C]-OCTANOICACID BREATH TEST FOR MEASUREMENT OF HEPATIC β-OXIDATION IN HIV PATIENTS RECEIVING NUCLEOSIDE-ANALOGUE REVERSE TRANSCRIPTASE INHIBITORS Antiviral Therapy 2001 6(Supplement 4):26 (abstract no. 34) GMN Behrens1, A Leodolter2, B Schmedes1, M Stoll1 and RE Schmidt1 The [13C]-octanoic acid breath test seems to be a reliable tool to assess impaired hepatic β-oxidation in NRTI-treated patients. Further studies to determine the prognostic value and the impact of treatment interventions of symptomatic and asymptomatic hyperlacatemia are warranted. |
| 35 | COULD ANTI-HEPATITIS C VIRUS TREATMENT WITH INTERFERON α AND RIBAVIRIN ENHANCE OR ENDURE LIOATROPHY IN PATIENTS PREVIOUSLY TREATED WITH ANTI-HIV MULTI THERAPY? Antiviral Therapy 2001 6(Supplement 4):27 (abstract no. 35) M Bentata, R Mansouri, P Honore and F Touam Lipoatrophy with or without weight loss, constitutional symptoms, polyneuropathies, hepatitis and hyperlactatemia have been observed in the first 3 months of treatment with IFN (± ribavirin) in seven patients with previous well tolerated anti-HIV treatment comprising NRTL In the present context, the combination of INFα or pegIFN and ribavirin seems to be the best treatment, but as very limited data are available on tolerance of anti-HCV treatment in HIV infection clinicians must be aware of there possible side-effects and carefully monitor the markers of mitochondrial toxicity after initiation of anti-HCV treatment. |
| 36 | SYMPTOMATIC HYPERLACTATEMIA AND LACTIC ACIDOSIS IN HIV- INFECTED PATIENTS TAKING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):28 (abstract no. 36) M Bickel, V Rickerts, K de Haas, T Lutz, S Staszewski and HR Brodt SHL and LA may be associated with stavudine, number of NRTIs, low BMI, female gender and chronic hepatitis. LDH and CK levels seem to parallel lactate levels. SHL and LA might also occur as an early complication of HIV treatment. |
| 37 | EVALUATION OF MITOCHONDRIAL EFFECTS IN TENOFOVIR DISIPROXIL FUMARATE-TREATED RATS AND PRIMATES Antiviral Therapy 2001 6(Supplement 4):28 (abstract no. 37) G Biesecker, S Karimi, J Desjardins, D Meyer, B Abbott and F Richardson Mitochondrial DNA content from treated rats was unchanged versus control in liver (8.4 versus 9.1), kidney (4.7 versus 5.1) and skeletal muscle (14.0 versus 8.3), although variation between animals in the same treatment. group was observed. Mitochondrial DNA content from treated primates was also unchanged from control. In summary, treatment with tenofovir DF did not effect mitochondrial DNA content, nor did treatment effect the level of mitochondrial enzymes, and there was no evidence of tissue pathology associated with mitochondrial injury at any dose level for tenofovir DF. |
| 38 | A PROSPECTIVE STUDY ON THE NEUROPSYCHIATRIC SIDE-EFFECTS AFTER INITIATION OF EFAVIRENZ IN HIV-1- INFECTED PATIENTS Antiviral Therapy 2001 6(Supplement 4):29 (abstract no. 38) J Blanch, E Martinez, A Rousaud, J-L Blanco, M-Á Garcia-Viejo, J-M Peri, J Mallolas, E De Lazzari, J De Pablo and JM Gatell Patients maintaining efavirenz showed a decrease in psychological distress related to self-image, depression and anxiety, without any effect on quality of life. Patients with lower school level, who feel physically and psychologically better at baseline than in the past, and who suffer from more distress due to physical complaints may be at greater risk to report more NPSE after efavirenz initiation. |
| 39 | ABDOMINAL FAT DISTRIBUTION ESTIMATED BY CT SCAN AND ANTHROPOMETRY. IN SEARCH OF AN OBJECTIVE DEFINITION OF LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):29 (abstract no. 39) F Blanco, T Garcia-Benayas, JM Gomez-Viera, T Corcuera, F Gomez, J Cabo, J de la Cruz, V Soriano and J Glez-Lahoz CT scan VAT/TAT values above the mean + 1 so recorded in HIV-positive naïve patients might be used as criterion for ALH diagnosis. LD characteristic changes observed in the abdomen (visceral fat accumulation and subcutaneous fat loss) are well reflected by anthropometric measurements (WHR and AB skinfolds). The association of undetectable VL with ALH might just reflect good adherence to antiretroviral treatment, which is considered the main LD pathogenic factor. |
| 40 | REASONS FOR PROTEASE INHIBITOR DISCONTINUATION IN A SELECTED COHORT OF HIV-PATIENTS Antiviral Therapy 2001 6(Supplement 4):30 (abstract no. 40) P Bonfanti, T Quirino, I Faggion, L Valsecchi, S Carradori, L Pusterla, P Fortuna, L Timillero, S Miccolis, C Magnan, A Gabbuti, R Cinelli, C Martinelli,S Landonio, F Parazzini and GM Vigevani From the curves regarding the estimated likelihood of treatment discontinuation due to any grade of adverse reaction, ritonavir clearly emerges as the least tolerated drug, while nelfinavir is the best tolerated after 2 years. If we consider the estimated likelihood of treatment discontinuation due to treatment failure patients treated with indinavir have the lowest probability of interruption. Looking the entire cohort, the onset of AEs is the main cause of first treatment interruption. |
| 41 | EFFECT OF LOW-DOSE RITONAVIR ON METABOLIC PARAMETERS IN THERAPY-NAÏVE SUBJECTS STARTED ON AMPRENAVIR/LAMIVUDINE/ABACAVIR (GSK COL30325) Antiviral Therapy 2001 6(Supplement 4):31 (abstract no. 41) A Burnside1, L Bush2, E DeJesus3, C Farthing4, G Boone5, A Hirani5 and J Hernandez5 In this pilot study, only moderate additional total cholesterol elevations were noted following ritonavir-boosting of amprenavir. Minimal changes in triglycerides and no changes in HDL cholesterol or glucose were observed. |
| 42 | DECREASED SERUM LEPTIN IS ASSOCIATED WITH ONSET OF LIPOATROPHY Antiviral Therapy 2001 6(Supplement 4):31 (abstract no. 42) BC Calhoun1, S Esper1, AM DePaoli2, SA Riddler1, R Evans1 and LA Kingsley1 The development of the lipoatrophy phenotype of HIV-LS following HAART initiation is associated with a decrease in serum leptin. Whether this decrease is explained exclusively by peripheral fat loss needs further study. This might suggest a reduced leptin level could contribute to the lipoatrophy syndrome. |
| 43 | A PILOT STUDY FOR THE USE OF PIOGLITAZONE IN THE TREATMENT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY LIPODYSTROPHY SYNDROMES Antiviral Therapy 2001 6(Supplement 4):32 (abstract no. 43) A Calmy, B Hirschel, L Karsegaard, D Hans, B Mermillod, C Pichard and CA Meier In this pilot study the use of pioglitazone appears to be reasonably safe in HIV-infected patients on HAART. Within the 6 months of treatment with pioglitazone, we noted an improvement of the lipodystrophic changes in four of the nine patients and a stabilization of metabolic alterations. Since pioglitazone is safe and may be efficacious in preventing the progression of metabolic alterations on HAART, a randomized and controlled trial will be required to validate these findings. |
| 44 | ANTHROPOMETRY DISTINGUISHES BETWEEN HIV-POSITIVE MEN AFFECTED AND UNAFFECTED WITH VISCERAL ADIPOSITY Antiviral Therapy 2001 6(Supplement 4):33 (abstract no. 44) P Chang1, DP Kotler2, ES Engelson2, J Gertner1, Q He2 and N Muurahainen1 In these HIV-positive men, there was correspondence between an anthropometric equation and excess VAT quantified on total body MRI. Hence, simple and convenient anthropometric measures provide a reasonable degree of accuracy in defining men with VA who might be included in clinical trials to reduce VAT. Further research is required to refine these equations in larger groups of men, validate equations in women, and produce normal, demographically adjusted ranges for VAT. |
| 45 | SERUM CORTISOL: DHEA RATIO IS THE BEST PREDICTOR OF CLINICAL EVOLUTION AND LIPID VARIATIONS ASSOCIATED TO LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):33 (abstract no. 45) N Christeff1, P de Truchis2, J-C Melchior2 and M-L Gougeon1 This study suggests that cortisol-DHEA ratio is the best predictor of clinical evolution and atherogenic lipid alterations in LD patients. |
| 46 | COMPARATIVE ADVERSE EFFECTS OF DIDANOSINE BUFFERED TABLETS (VIDEX) AND ENTERIC COATED CAPSULES (VIDEXEC) Antiviral Therapy 2001 6(Supplement 4):34 (abstract no. 46) SK Chuck and D Areff Together, an easier dosing regimen and better tolerability with less frequent, less severe and less bothersome adverse effects are likely explanations for improved adherence with VidexEC. |
| 47 | MONITORING OF ABACAVIR HYPERSENSITIVITY REACTION BY PHARMACISTS Antiviral Therapy 2001 6(Supplement 4):35 (abstract no. 47) SK Chuck, A Condra, DL May, PD Powers, C Landers and D Hurst An unacceptable HSR knowledge level of 89% exists. HSR symptoms are prevalent, especially at initiation and at 1 month. Symptom history is essential to discern suspected HSR. Pharmacists playa vital role in educating patients and screening for HSR, resulting in timely HSR diagnosis. |
| 48 | L6 MYOTUBES: THE EFFECTS OF ANTIRETROVIRAL PROTEASE INHIBITORS ON SUGAR TRANSPORT AND CELLULAR GLUCOSE TRANSPORTERS Antiviral Therapy 2001 6(Supplement 4):35 (abstract no. 48) SP Colby-Germinario1, C Cammalleri1, 2 and RJ Germinario1, 2, 3, 4 Our data suggest that translocation of GLUT transporters may not be the mechanism involved in PI-induced increased 2-DG transport. Regarding the insulin resistance seen in highly active antiretroviral therapy-treated AIDS patients, our results provide clues to uncovering key factors involved. |
| 49 | ACCELERATED ATHEROSCLEROSIS IN MEN INFECTED WITH HIV Antiviral Therapy 2001 6(Supplement 4):36 (abstract no. 49) 1J Currier, F Boyd2, B Burtce3, C Dezii3, H Kawabata3, D Lilienfeld3 and S Hodder3 These data suggest an association between HIV infection and/or therapy and accelerated coronary atherosclerosis in young (but not older) men. Due to this study's lack of data on other important risk factors for CHD, such as smoking, further investigations are clearly needed. Nonetheless, modification of CHD risk factors should be considered in these individuals. |
| 50 | SUCCESSFUL SURGICAL THERAPY WITH POLYVINYL GEL MICRO SPHERES OF SEVERE FACIAL LIPOATROPHY: RESULTS AFTER 1 YEAR OF FOLLOW-UP Antiviral Therapy 2001 6(Supplement 4):36 (abstract no. 50) V Del Pino1, JM Arevalo1, S Moreno2 and F Dronda2 A simple refill method with an acrylic substance can be a safe therapeutic procedure for atrophy of the face. Self-reported results from the patients were excellent after 1 year of follow-up. |
| 51 | PREDICTION OF THE RISK OF CORONARY HEART DISEASE IN HIV- INFECTED PATIENTS ON COMBINATION ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):37 (abstract no. 51) P Domingo, MA Sambeat, A Fontanet, F Montero, J Cadafalch, M Gurgui and G Vazquez The mean 10-year CHD risk was 6.6% for HIV-infected patients treated with antiretroviral therapy. Lipodystrophy seem to increase the 10-year CHD risk, but not to significant levels, whereas NNRTI-treated patients exhibited the highest risk among our patients. |
| 52 | VASCULAR DISEASE IN HIV-INFECTED PATIENTS: A COMPARATIVE STUDY OF TWO DIFFERENT PERIODS (1994-1997 VERSUS 1998-2000) IN A SINGLE INSTITUTION Antiviral Therapy 2001 6(Supplement 4):38 (abstract no. 52) F Dronda, S Moreno, A Antela, MJ Perez-Elias, JL Casado, V Munoz and A Moreno Our data suggest that the risk of vascular disease in HIV-infected patients on HAART is not increased with respect to that of untreated HIV- infected patients. However, the administration of HAART confers longer survival after the development of a cardiovascular complication. |
| 53 | EFFECTS OF STORAGE, PROCESSING DELAYS AND INTER-LABORATORY VARIATION, ON PLASMA LACTATE CONCENTRATIONS: ACTG 5099 Antiviral Therapy 2001 6(Supplement 4):38 (abstract no. 53) MP Dubé1, R Zackin2, RG Gibson1, B Alston3 and K Mulligan4 Three months of storage of NaF/KOx plasma had no significant effect on lactate measurements. It is acceptable to handle samples in this manner for later analysis. Plasma collected on EDTA and subjected to delays in processing is unacceptable. Shipping and a single thaw-refreeze cycle had no effect. Due to potential inter-laboratory variation, in studies where cross-sectional lactate measurements are a major end-point, use of a single laboratory may be preferable. |
| 54 | INITIATION OF INDINAVIR- OR AMPRENAVIR-BASED REGIMENS IS ASSOCIATED WITH SHORT-TERM REDUCTIONS IN TISSUE PLASMINOGEN ACTIVATOR ANTIGEN LEVELS Antiviral Therapy 2001 6(Supplement 4):39 (abstract no. 54) MP Dubé1, S Shankar1, TA Buchanan2, M Deeg1, D Goodwin3, J Hernandez3 and FR Sattler2 Over 8 weeks, levels of tPA antigen fell in PI-naïve subjects initiating indinavir who experienced decreased insulin sensitivity and in subjects receiving amprenavir who did not. These findings suggest that short-term improvements in a marker of impaired thrombolysis can occur during successful antiretroviral therapy, and that this improvement may occur irrespective of short-term declines in insulin sensitivity. |
| 55 | FAILURE TO MAINTAIN LONG-TERM ADHERENCE TO HIGHLY ACTIVE ANTIRETROVIRAL THERAPY: THE ROLE OF LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):39 (abstract no. 55) S Duran1, M Saves2, B Spire1, V Cailleton1, A Sobel3, P Carrieri1, D Salmon4, JP Moatti1, C Leport5 and the APROCO study group Patients' self-perception of change in their body shape is an important determinant of adherence failure. Specific support should be implemented for patients declaring lipodystrophy-related symptoms in order to help them maintain adherence to HAART over time. |
| 56 | EFAVIRENZ IS EFFECTIVE AND WELL TOLERATED IN AN INNER CITY POPULATION Antiviral Therapy 2001 6(Supplement 4):40 (abstract no. 56) H Edelstein, M Wilson, M DeLeo and L Reynolds The overall AEs and discontinuation rate of efavirenz was higher than in most studies, probably reflecting a 'real life' situation rather than a study population. Ethnic variation may also have played a part, and there was a suggestion that Asians were more likely to stop drug (P=0.06) than other groups. The crossover of side-effects due to active drug abuse and those due to efavirenz can create a confusing clinical picture. Efavirenz was effective and useful in a wide variety of patients, including illicit drug users and ethnic minorities. |
| 57 | INFLUENCE OF BODY COMPOSITION ON TOTAL BODY AND REGIONAL BONE MINERAL CONTENT IN HIV-INFECTED PATIENTS WITH OR WITHOUT THE HIV/HIGHLY ACTIVE ANTIRETROVIRAL THERAPY-ASSOCIATED LIPODYSTROPHY SYNDROME Antiviral Therapy 2001 6(Supplement 4):41 (abstract no. 57) J Falutz and L Rosenthal Both FM and LBM may determine total body and regional BMC in HIV-positivepatients, as in HIV-negative patients. Differences in correlations between body composition and BMC as well as in determinants of BMC in HAL-negative versus -positive patients need to be clarified to determine clinical relevance. |
| 58 | SHORT-AND LONG-TERM DESCRIPTIVE ASPECTS OF CHANGES IN MORPHOLOGIC FEATURES OF THE HIV/HIGHLY ACTIVE ANTIRETROVIRAL THERAPY-ASSOCIATED LIPODYSTROPHY SYNDROME Antiviral Therapy 2001 6(Supplement 4):41 (abstract no. 58) J Falutz, J Cox, A Giannakis, VK Nguyen, J Szabo and C Tsoukas Upon short-term re-evaluation, 25% of evaluated patients had different morphologic characteristics assessedcompared to baseline. After 2 years, 33% of re-evaluated patients had different features documented. Whether these re-classifications represent a true change or misclassification is unknown. The possible lack of reliability of the currently accepted method of describing patients' HAL-related features is concerning. Standardized assessment tools must be developed. |
| 59 | AIDS LIVER DISEASE (1995 VERSUS 2001) Antiviral Therapy 2001 6(Supplement 4):42 (abstract no. 59) M Feregrino-Goyos, R Alvarado-Diez, JL Villalobos, O Ruíz-Campos, G Eid-Lidt and H Gallegos-Perez Both groups had similar clinical, laboratory and ultrasonographic and MRI findings without statistically significant differences. We believe that the steatosis is secondary to HIV and OI more than ARV toxicity. |
| 60 | CARDIOVASCULAR DISEASE RISK IN HIV- INFECTED PERSONS Antiviral Therapy 2001 6(Supplement 4):43 (abstract no. 60) C Fichtenbaum, J Wall and M David There is a significant prevalence of risk for the progression of CVD in persons with HIV infection. The risk is higher among those treated with PIs. Cardiovascular risk should be assessed in all persons with HIV infection and risk reduction efforts should be aggressively pursued. |
| 61 | NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS: NO RELATIONSHIP BETWEEN INHIBITION OF MITOCHONDRIAL DNA REPLICATION AND METABOLIC FUNCTION IN AN ADIPOCYTE CULTURE MODEL Antiviral Therapy 2001 6(Supplement 4):43 (abstract no. 61) OP Flint, R Mulvey, S Wang, W Fenderson, W-P Yang and RA Parker NRTIs are without direct effect on differentiated adipocyte viability, lipogenesis, mtDNA, or mt function in vitro at therapeutically relevant concentrations. Effects on adipocyte mtDNA seen at high stavudine or zidovudine concentrations are unrelated to reductions in lipogenesis, which occurred prior to reduction in mtDNA quantity. Further, NRTIs do not reduce the differentiation capacity of preadipocytes in this model. The data do not support the hypothesis of NRTI-induced irreversible mitochondrial toxicity in adipose tissue as a mechanism for lipodystrophy. |
| 62 | DYSLIPIDEMIA AND BODY COMPOSITION EFFECTS OF TESTOSTERONE CYPIONATE IN A GROUP OF PEOPLE LIVING WITH HIV/AIDS IN ONTARIO, CANADA Antiviral Therapy 2001 6(Supplement 4):44 (abstract no. 62) P Ford1, S Tenzif2, W Wobeser1, R Ross1 and D Jenkins3 Changes in serum lipid profile, insulin resistance, and body composition in addition to history of HIV infection in the TC group can increase their risks of cardiovascular events. A follow-up study is underway. |
| 63 | ACETYL-CARNITINE DEFICIENCY AND MITOCHONDRIAL DNA-DEPLETION IN HIV PATIENTS TREATED WITH ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):44 (abstract no. 63) G Friese1, K Froese1, M Jaksch2, J Kreuder3, Th Discher1 and J Lohmeyer1 Compared to normal ranges mean free carnitine, acetyl-carnitine and total carntine levels were significantly decreased in HIV-infected patients irrespective ART treatment. ART treatment, however, further enhanced this acetyl-carnitine deficiency probably by mitochondrial DNA depletion. |
| 64 | ANTHROPOMETRY AND CT SCAN TO ESTIMATE ABDOMINAL FAT DISTRIBUTION. IS THERE ANY CORRELATION? Antiviral Therapy 2001 6(Supplement 4):45 (abstract no. 64) T García-Benayas, F Blanco, JM Gómez-Viera, T Corcuera, F Gómez, J Cobo,J de la Cruz, V Soriano and J Glez-Lahoz In HIV-positive patients without abdominal fat accumulation, abdominal and suprailiac skinfolds correlate well with CT scan in assessing the subcutaneous fat compartment. The correlation between WHR and CT scan is not good enough to consider the WHR as a surrogate parameter of visceral fat in the abdomen. |
| 65 | HYPERLACTATEMIA IN 59 PATIENTS DURING A 4-YEAR FOLLOWED-UP COHORT STUDY: IMPLICATIONS FOR ROUTINE LACTATE MONITORING Antiviral Therapy 2001 6(Supplement 4):46 (abstract no. 65) Y Gérard, F Ajana, Y Yazdanpanah, X De La Tribonniere, V Baclet, S Alfandari, M Valette, I Alcaraz, A Cheret and Y Mouton Frequency, seriousness, potential neurologic sequelae and frequent paucity of abnormal symptoms justify systematic measurements of blood lactate levels between 6 and 12 months after initiating or modifying a therapy with nucleoside analogues. |
| 66 | HEPATIC LIPASE ACTIVITY IS INCREASED AND LIPOPROTEIN LIPASE ACTIVITY IS DECREASED IN HYPERTRIGLYCERIDEMIC PATIENTS RECEIVING ANTI-HIV THERAPY Antiviral Therapy 2001 6(Supplement 4):46 (abstract no. 66) T Green1, J Frohlich1, J Montaner2 and G Bondy1 The decreased LPL activity observed in our cohort may contribute to the high serum TG. The increased activity of HL may explain the finding of low HDL cholesterol in this group of patients. LPL hydrolyses TG in chylomicrons and very low-density lipoprotein (VLDL) particles. HL hydrolyses TG on chylomicrons and VLDL remnants and plays a role in remodelling LDL and HDL particles. LPL is important for clearance of TG rich lipoproteins. The decreased LPLactivity in our cohort suggests that the elevation in serum TG is partly the result of decreased TG clearance by LPL. Increased HL activity has been linked to decreased HDL cholesterol, as was observed in our group. Increased HL activity is also associated with decreased size and increased density of both HDL and LDL particles, both of which are commonly seen in HIV dyslipidemia. |
| 67 | BODY IMAGE PERCEPTION TESTS FOR LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):47 (abstract no. 67) G Guaraldi1, G Orlando1, R Murri2, E Orlandi1, R Covezzi1, G Amorico1, A Bedini1 and R Esposito1 Given the dysmorphic changes due to lipodystrophy, the psychological impact of this condition is high and influenced by the individual body image perception. Nevertheless, BCS, MBSRQ and BAT questionnaires are unable to discriminate the attitudinal aspects of body image perception in HIV-infected people with lipodystrophy. |
| 68 | SELF-ESTIMATE QUESTIONNAIRES ARE RELIABLE FOR LIPODYSTROPHY DIAGNOSIS Antiviral Therapy 2001 6(Supplement 4):48 (abstract no. 68) G Guaraldi1, G Orlando1, R Murri2, E Orlandi1, R Covezzi1, G Amorico1, A Bedini1 and R Esposito1 Self-estimate of body size is accurate in HIV-infected women. Self-assessment of physical features of lipodystrophy is reliable, thus self-estimate questionnaires are reliable for lipodystrophy diagnosis. |
| 69 | SUSTAINED BENEFITS OF METFORMIN THERAPY IN HIV LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):48 (abstract no. 69) C Radigan1, J Rabe1, B Davis2, N Basgoz2 and S Grinspoon1 There was no increase in lactic acid levels associated with metformin. These data demonstrate a sustained benefit of metformin to reduce insulin resistance in patients with HIV infection and lipodystrophy. |
| 70 | RANDOMIZED PHASE III TRIAL OF OXYMETHOLONE FOR THE TREATMENT OF HIV WASTING AND LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):49 (abstract no. 70) UR Hengge1, K Stocks1, S Unger1, S Faulkner2, M Goos1 and R Dudley2 Oxymetholone was found to have true anabolic effects in a double-blind, placebo-controlled Phase III trial. The twice daily (100 mg/day) regimen appeared equally effective to three times daily (150 mg/day) dosing while displaying reduced liver toxicity. Due to its favorable protein anabolism, it may be recommended for therapy of wasting and lipodystrophy in HIV-infected subjects. |
| 71 | PREVALENCE, RISK FACTORS AND OUTCOME OF HYPERLACTATEMIA IN HIV-INFECTED PATIENTS Antiviral Therapy 2001 6(Supplement 4):49 (abstract no. 71) L Hocqueloux1, C Alberti2, Y Beuzard3, O Carel1 and JM Molina1 HL is frequent in patients under antiretroviral therapy and might be associated with the use of some NRTIs, such as didanosine or stavudine. However, symptomatic HL is rare and long-term outcome of patients with HL does not seem to be poorer than controls. |
| 72 | A COMPARATIVE, RETROSPECTIVE ANALYSIS COMPARING LIPID LEVELS IN INDIVIDUALS TREATED WITH RITONAVIR VERSUS NON-RITONAVIR-CONTAINING ANTIRETROVIRAL REGIMENS Antiviral Therapy 2001 6(Supplement 4):50 (abstract no. 72) SE Hulse1, KM Bleichner1, P Keiser2 and N Nassar1 Ritonavir-containing regimens are more likely to be associated with increased cholesterol and triglycerides than non-ritonavir-containing regimens. Given the high frequency of nelfinavir in the non-ritonavir regimens, this drug is primarily responsible for the observed result. |
| 73 | HYPERTENSION AND RENAL DISEASE IN HIV-POSITIVE CAUCASIAN PATIENTS Antiviral Therapy 2001 6(Supplement 4):50 (abstract no. 73) O Jung1, M Bickel2, T Ditting1, T Lutz2, CBetz1, EB Helm2, S Staszewski2 and H Geiger1 Hypertension in HIV-infected patients is highly associated with cardiac and renal disorders. Further studies should be done to elucidate the pathogenesis of the unusual frequent renal changes observed. |
| 74 | METABOLIC ABNORMALITIES ASSOCIATED WITH TWO DISTINCT PHENOTYPES OF HIV-ASSOCIATED LIPODYSTROPHY SYNDROME Antiviral Therapy 2001 6(Supplement 4):51 (abstract no. 74) LA Kingsley1, R Li2, S Cole2,E Smit2, S Riddler1, JS Chmiel3, F Palella3, B Visscher4, J Oishi4, E Taylor2, A Dobs2, C Williams5 and R Evans1 Although men with phenotype II HIV-LS had somewhat lower lipoprotein A and higher haemoglobin A1c, the substantial overlap in these and many other metabolic abnormalities limits clear discrimination of these two phenotypes. Our results, both positive and negative, are limited by imprecision due to small numbers and possible confounding by factors other than age. Other indicators of metabolic dysregulation must be examined as well as hypotheses of single metabolic abnormalities sufficient to explain these observations. |
| 75 | THE DEVELOPMENT OF LABORATORY CARDIOVASCULAR RISK FACTORS IN PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY DURING 24 MONTHS FOLLOW-UP Antiviral Therapy 2001 6(Supplement 4):52 (abstract no. 75) K Koppel, G Bratt and E Sandstrom PI-HAART is related to increased levels of TG, cholesterol, LDL-C, Lp(a), PAI-1 and fbg. During PI-HAART LDL-C and Lp(a) increased initially while Lp(a) and PAI-1 continued to increase for a longer period. After the change to non-PI HAART LDL-C decreased. Lp(a) continued to increase in efavirenz-based HAART and PAI-1 continued to increase in abacavir-based HAART. After treatment interruption, TG and LDL-C decreased. Thus, LDL-C and possibly Lp(a) might be the parameters most closely associated with PI-HAART, while the hypertriglyceridemia and hypercoagulability might be influenced by other components. Continuous followup of these factors during HAART will further enlighten these abnormalities. |
| 76 | PREDICTORS OF PROTEASE INHIBITOR-ASSOCIATED ADVERSE EVENTS Antiviral Therapy 2001 6(Supplement 4):52 (abstract no. 76) S Landonio1, P Bonfanti1, I Faggion1, E Ricci2, L Valsecchi1, S Carradori1, L Pusterla1, P Fortuna1, L Timillero1, S Miccolis1, C Magnani1, A Gabbuti1, R Cinelli1, F Parazzini2, T Quirino1 and GM Vigevani1 Our study confirms that the antiretroviral treatment should be highly personalized as regarding the individual variables as for drug safety data. |
| 77 | RISK FACTORS OF HYPERSENSITIVITY REACTIONS TO ABACAVIR Antiviral Therapy 2001 6(Supplement 4):53 (abstract no. 77) M Leaty-Bernard, H Peyrière, S Hansel and J Reynes The incidence of HSR to abacavir observed in our cohort was 11.9%. Our data suggest that medical history and virological status may contribute to identify a population of patients with higher risk of HSR to abacavir. |
| 78 | DELAYED HYPERSENSITIVITY TO ABACAVIR IN PATIENTS WITH HIV-1 INFECTION Antiviral Therapy 2001 6(Supplement 4):54 (abstract no. 78) W Leti, A Esposito, ML Bernardi, R Fantini, I Mezzaroma, E Pinter and F Aiuti Five of 23 (21%) patients in treatment with abacavir presented rash. Allergologic anamnesis for ADRs was positive in 3/5 patients. Skin tests were negative both at 20 min and at 24 h. Patch-tests for abaca vir were positive in 4/5 patients. All patients took and tolerated antiretroviral drugs used in association with abacavir. These data exclude a type-I (IgE-mediated) immunological mechanism and show the presence of a type IV (cell mediated) reaction. This mechanism was not known in relation to antiretroviral therapy up to this time. |
| 79 | RATE OF OSTEOPOROSIS/ASEPTIC OSTEONECROSIS/HIP FRACTURE IS THE SAME FOR USERS OF STAVUDINE AND USERS OF ZIDOVUDINE: A PHARMACOEPIDEMIOLOGIC INVESTIGATION OF 14000 HIV-POSITIVE PERSONS IN THE MEDICAL POPULATION Antiviral Therapy 2001 6(Supplement 4):54 (abstract no. 79) DE Lilienfeld and H Kawabata We conclude that there is no difference in the risk of osteoporosis, aseptic osteonecrosis or hip fracture among users of stavudine and users of zidovudine in this population. |
| 80 | HIGH RATE OF THYROID AUTOIMMUNITY AND DYSFUNCTION IN HIV-INFECTED ADULTS RECEIVING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):55 (abstract no. 80) M Loignon, M Martin and E Toma Thyroid autoimmunity and dysfunction as well as other concomitant metabolic complications are common in patients receiving HAART. Their diversity and occurrence at different levels of CD4 counts and HIV viral loads underline their multifactorial and complex mechanisms. |
| 81 | IMPROVEMENTS IN SYMPTOMATIC HYPERLACTATEMIA ARE OBSERVED AFTER 12 WEEKS WHEN STAVUDINE IS REPLACED BY EITHER ABACAVIR OR ZIDOVUDINE Antiviral Therapy 2001 6(Supplement 4):55 (abstract no. 81) T Lonergan1, G Mccomsey2, R Fisher3, P Shalit4, T File5,D Ward6, V Williams3, L Lindsey3 and J Hernandez3 Subjects having symptomatic hyperlactatemia showed early improvements in associated laboratory markers and clinical symptoms when stavudine was replaced by either abacavir or zidovudine. |
| 82 | BONE MASS LOSS RISK IN HIV-INFECTED PATIENTS TREATED WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY INCLUDING PROTEASE INHIBITORS Antiviral Therapy 2001 6(Supplement 4):56 (abstract no. 82) GM Calia1, C Lovigu1, M Mannazzu1, F Chessa2, A Falchi2, MS Mura1 and G Madeddu2 Both osteoporosis and osteopenia occurred in HIV PI-treated patients with a significantly higher incidence/severity of osteoporosis than naïve and non-PI regimen recipients in our cases. Careful selection of pre-PI treatment patients for preventive osteoporosis therapy and accurate treatment follow-up could be necessary. |
| 83 | ANALYSIS OF CHANGES IN METABOLIC AND MORPHOLOGICAL ABNORMALITIES IN HIV-POSITIVE INDIVIDUALS, WITH HIV-ASSOCIATED LIPODYSTROPHY, CHANGING REGIMENS Antiviral Therapy 2001 6(Supplement 4):57 (abstract no. 83) PWG Mallon, J Miller, A Carr and D Cooper There were no significant changes in lipids, glucose, total fat, peripheral fat and abdominal fat between the two groups. This study fails to show any significant benefit from switching therapy in those suffering from the metabolic or morphological abnormalities seen with HIV-associated lipodystrophy. |
| 84 | PROSPECTIVE EVALUATION OF THE DEVELOPMENT OF METABOLIC AND MORPHOLOGICAL ABNORMALITIES IN A GROUP OF ANTIRETROVIRAL-NAÏVE, HIV-POSITIVE INDIVIDUALS BEGINNING ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):57 (abstract no. 84) PWG Mallon1, 2, J Miller1, DA Cooper1, 2 and A Carr2 These results show that metabolic abnormalities can occur in the absence of significant changes in body composition and that these abnormalities may not be due solely to the use of protease inhibitors. This supports a role for several classes of drugs in the development of HIVassociated lipodystrophy. |
| 85 | ASSESSMENT OF BONE DENSITY AND BONE METABOLISM IN LONG-TERM HIV-INFECTED INDIVIDUALS WITH HIGH ANTIRETROVIRAL EXPOSURE Antiviral Therapy 2001 6(Supplement 4):58 (abstract no. 85) S Mauss1, TB West2 and G Schmutz1 We observed a higher than expected prevalence of osteopenia, but not osteoporosis in patients with long-term HIV-infection and a high exposure to antiretroviral combination therapy, who should be at the highest risk to develop osteopenia or osteoporosis according to recent studies. Elevated markers of bone resorption were present in a considerable proportion of the osteopenic patients. Lactate seemed not to be associated with osteopenia. In addition to antiretrovirals and HIV-infection itself, additional factors like physical inactivity and reduced nutritional intake should be assessed in further studies. |
| 86 | HYPERCHOLESTEROLEMIA AND HIV - TIME TO RECONSIDER A DOGMA? Antiviral Therapy 2001 6(Supplement 4):58 (abstract no. 86) S Mauss1, J Stechel2, R Willers3, G Schmutz1 and WO Richter4 The most common cause for high total cholesterol in HIV-positive patients is an elevation of VLDL. As VLDL contains about 20% cholesterol in addition to triglycerides the increased concentration of VLDL leads to an elevated total cholesterol. Because of this, the cardiovascular risk in the majority of HIV-positive patients with hypercholesterolemia may be lower than expected from total cholesterol. Less than one-third of the patients with high total cholesterol had an elevated LDL-cholesterol. This may be due to genetically transmitted hypercholesterolemia (as in the normal population) or an increased catabolism of VLDL to LDL. To estimate further the cardiovascular risk a more detailed analysis of the VLDL-composition is underway. |
| 87 | COMPARISON OF LIPID PROFILES ON NELFINAVIR- VERSUS LOPINAVIR/RITONAVIR-CONTAINING REGIMEN Antiviral Therapy 2001 6(Supplement 4):59 (abstract no. 87) GA McComsey1, 2, D Antosh1, 2 and Alice Chu3 Nelfinavir-containing regimen are associated with significant increase in cholesterol, but not in triglyceride levels. By contrast, lopinavir/ritonavir-containing regimen are associated with significant increase in both cholesterol and triglycerides levels. This emphasizes the need to study the metabolic complications of each PI separately. |
| 88 | ELEVATED LACTATE LEVELS ARE UNCOMMON, EVEN IN HEAVILY PRETREATED HIV-INFECTED SUBJECTS Antiviral Therapy 2001 6(Supplement 4):60 (abstract no. 88) GA McComsey1, 2, L Yau3, H Southwell2, B Gripshover2, R Asaad2, H Valdez3, R Salata2 and MM Lederman2 The value of routine lactate measurements remains uncertain. Consistent collection methods should be used to adequately assess the true prevalence of hyperlactatemia. Our findings suggest that age, treatment with NRTIs and with stavudine may have significant roles in the occurrence of hyperlactatemia. HIV infection itself may also contribute to the hyperlactatemia; this requires further study. |
| 89 | POSSIBLE RELATION BETWEEN LIPODYSTROPHY AND THE DEVELOPMENT OF RENAL COLIC DURING THERAPY WITH INDINAVIR Antiviral Therapy 2001 6(Supplement 4):60 (abstract no. 89) P Meraviglia1, M Bevilacqua2, E Angeli1, V Righini2, F De Sorbo1 and A Cargnel1 Renal colic is a frequent complication of indinavir therapy in our cohort. Indinavir does not seem to be related to an impairment of renal function, but a longer follow-up is needed to verify if prolonged exposure may favour the occurrence of renal alterations. The presence of lipodystrophy, in relation to the modification of body composition, may be related to the development of renal colic, but larger cohort study should be encouraged to understand the pathogenesis. |
| 90 | VASCULAR COMPLICATIONS IN HIV-POSITIVE PATIENTS UNDER HIGHLY ACTIVE ANTIRETROVIRAL THERAPY REGIMENS CONTAINING PROTEASE INHIBITORS Antiviral Therapy 2001 6(Supplement 4):61 (abstract no. 90) P Meraviglia, E Angeli, F Del Sorbo, G Dedivitiis and A Cargnel It is difficult to define pathogenic mechanisms of these events and to correlate specifically to one PI, even if indinavir seems to be frequently related. Further studies are necessary to understand the real incidence and pathogenesis of vascular complications in HIV-positive patients. The increase of life expectancy, the presence of iatrogenic metabolic disorders, associated to risk factors, can favour the occurrence of vascular diseases; a careful screening should be encouraged in patients starting PI therapy. |
| 91 | THE EFFECT OF STRUCTURED THERAPY INTERRUPTIONS ON THE EVOLUTION OF LIPID ABNORMALITIES AND BODY FAT IN PATIENTS WITH PRIMARY HIV-1 INFECTION Antiviral Therapy 2001 6(Supplement 4):62 (abstract no. 91) A Milinkovic, E Martinez, S Vidal, A del Rio, JB Perez-Cuevas, I Conget,M Ruiz, JL Blanco, J Mallolas, JM Mira and JM Gatell The structured interruption of successful highly active antiretroviral therapy (HAART) in patients with primary HIV-1 infection seems to be associated with an increase of body fat and a decrease of lipid abnormalities that is lost after reintroduction of HAART. These findings support a further investigation of this strategy of therapy for treating lipodystrophy in HIV-1-infected patients. |
| 92 | VALUE OF PATCH-TESTING TO INVESTIGATE ANTIRETROVIRAL DRUG ERUPTIONS Antiviral Therapy 2001 6(Supplement 4):62 (abstract no. 92) B Milpied-Homsi1, C Brunet-François1, I Falconi2, MF Charonnat1, C Le Bihan2, V Reliquet1 and F Raffi1 These preliminary results support the interest of antiretroviral drug patch-testing in HIV-1 patients with cutaneous ADR and need to be confirmed by further studies. |
| 93 | TOXICITY PROFILE OF ANTIRETROVIRAL DRUGS IN NAÏVE PATIENTS STARTING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN ROUTINE CLINICAL PRACTICE Antiviral Therapy 2001 6(Supplement 4):63 (abstract no. 93) A Moreno, MJ Perez-Elias, JL Casado, A Antela, F Dronda, E Bermudez, V Munoz, L Moreno, C Quereda and S Moreno In clinical practice a significant proportion of patients starting HAART develop toxicity. It usually leads to drug withdrawal despite being mild in most cases. There were not unexpected AE when considering each drug individually. The individual drug profile should be considered when designing first-line regimens. |
| 94 | HAEMATOLOGICAL TOXICITIES OF PEGYLATED-INTERFERON PLUS RIBAVIRIN IN HEPATITIS C VIRUS/HIV CO-INFECTED PATIENTS WHO RECEIVE CONCOMITANT ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):63 (abstract no. 94) L Moreno, C Quereda, ME Moreno, A Moreno, M Uriarte, A Antela, JL Casado and S Moreno Nearly half the patients who receive concomitant therapy for hepatitis C virus and HIV infections develop significant haematological toxicity. Antiretroviral regimens that include zidovudine seem to be associated with a higher rate of significant anaemia and drug discontinuation than those that include stavudine. |
| 95 | HERNIA OF THE ABDOMINAL WALL - A HIGH INCIDENCE IN HIV- INFECTED PATIENTS Antiviral Therapy 2001 6(Supplement 4):64 (abstract no. 95) L Morfeldt1, A Sundstrom2, R Olofsson2, G Thulin2, B Åkerlund3, K Koppel4, A Karlsson4, L Flamholc5, C Håkangård5, H Granholm1, A Liedberg2 and Ö Mortimer on behalf of The HivBivus Collaborative Group In the HivBivus registry we have noted a high incidence of abdominal wall hernia. There seems to be an association between the hernia and ART and/or the intra-abdominal fat accumulation. However, at this point one. can only speculate about the causes - could it be that the hernia develops due to mechanical factors (pressure from large fat masses), or could it be that ART and/or HIV infection per se induce weakening of the supportive tissue in general? We will continue to survey the incidence of all hernias within the HivBivus cohort. Studies of the pathophysiological mechanism involved seem highly warranted. |
| 96 | INCREASED RISK OF LIVER DAMAGE IN HIV-INFECTED PATIENTS RECEIVING ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):64 (abstract no. 96) Ö Mortimer1, A Sundström1, B Åkerlund2, K Koppel3, A Karlsson3, L Flamholc4 and L Morfeldt5 on behalf of The HivBivus Collaborative Group In this retrospective survey of the 1072 patients of the HivBivus cohort, liver damage of clinical significance was found to be common. In about half of the cases the antiretroviral therapy may have been the cause, or partially the cause, of the liver reaction. In patients with chronic hepatitis the risk for hepatotoxicity seems particularly high and such patients should be monitored closely while on therapy. As the hepatotoxic effects of ART may accumulate with time, continued surveillance for an increase of the incidence of liver damage is warranted. |
| 97 | AN OPEN-LABEL RANDOMIZED TRIAL OF SUBSTITUTION OF STAVUDINE OR PROTEASE INHIBITORS/NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS TO AN ABACAVIR-BASED THERAPY FOR METABOLIC DISTURBANCES IN PERSONS ON FIRST-LINE THERAPY Antiviral Therapy 2001 6(Supplement 4):65 (abstract no. 97) GJ Moyle, C Baldwin and BG Gazzard Abacavir can safely maintain viral load when substituting for PI, NNRTI or stavudine in first-line regimens. Data on metabolic outcomes at week 24 will be presented. |
| 98 | HYPERLACTATAEMIA AND LACTIC ACIDOSIS DURING ANTIRETROVIRAL THERAPY: RELEVANCE, REPRODUCIBILITY AND POSSIBLE RISK FACTORS Antiviral Therapy 2001 6(Supplement 4):66 (abstract no. 98) GJ Moyle, D Datta, S Mandalia, J Morlese, D Asboe and BG Gazzard Screening of lactate is practical but of limited use in asymptomatic individuals on antiretroviral therapy. Raised lactate represents part of a spectrum of lactate and acid-base disturbance on antiretroviral therapy that infrequently includes lactic acidosis. Whilst female gender and didanosine use may be risk factors of lactic acidosis, only didanosine use is associated with an increased risk of hyperlactataemia. |
| 99 | THE LIPODYSTROPHY SYNDROME: A NEW STIGMA FOR HIV-INFECTION? Antiviral Therapy 2001 6(Supplement 4):66 (abstract no. 99) M Oette1, P Juretzko2, A Kroidl1, A Theisen1, A Sagir1, M Wettstein1, J Siegrist2 and D Häussinger1 In our cohort LDS was prevalent in 17-33%, depending on the location. LDS was not associated with a significant deterioration of well being. However, the development of LDS leads to the feeling of the individuals to be recognizable as HIV-positive by outer appearance. Thus, LDS may result in substantial social disadvantages for affected persons. |
| 100 | DIFFERENTIATION OF HIV PROTEASE INHIBITORS IN MODELS OF LIPID AND GLUCOSE METABOLISM AND GENE EXPRESSION IN ADIPOCYTES AND HEPATOCYTES Antiviral Therapy 2001 6(Supplement 4):67 (abstract no. 100) RA Parker, S Wang, D Meyers, W Fenderson, R Mulvey, J Leet, A Peters, T Harrity, W-P Yang and OP Flint The data support current hypotheses that PIs inhibit GLUT4, suppress adipocyte differentiation, and disturb hepatic lipid and lipoprotein production. Atazanavir's lesser effects on adipocyte and hepatocyte lipid metabolism compared to other PIs tested appears to correlate with the absence of dyslipidemia in clinical studies' of atazanavir to date. It is proposed that these models may predict PI-induced metabolic dysregulation in the clinic. |
| 101 | THE EFFECTS OF POLYLACTIC ACID IN THE THERAPY FOR THE LIPOATROPHY OF THE FACE Antiviral Therapy 2001 6(Supplement 4):68 (abstract no. 101) R Polo1, M Ortiz2,J Babe1,S Martinez1, P Madrigal1 and M Gonzalez-Muñoz1 Our data confirm the positive effects of intradermal injections of PLA on facial fat wasting while maintaining antiretroviral therapy. |
| 102 | CENTRAL ADIPOSITY AND CARDIOVASCULAR DISEASE RISK IN A GROUP OF HIV-POSITIVE PEOPLE TAKING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):68 (abstract no. 102) V Pribram In this study, associations were found between hyperlipidaemia, central adiposity, race, gender and type of HAART. All measures of body fat were equally able to detect stronger associations, while indices of abdominal fat distribution proved better indicators of weaker correlations. Interventions to reduce central adiposity may help reduce the risk of cardiovascular disease in this population. |
| 103 | SYMPTOMATIC HYPERLACTATEMIA IN HIVJHEPATITIS CVIRUS CO-INFECTED PATIENTS UNDER TREATMENT WITH INTERFERON-α- RIBAVIRIN AND ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):69 (abstract no. 103) C Quereda, L Moreno, ME Moreno, A Moreno, E Bermúdez, F Dronda, MJ Perez-Elías and S Moreno Symptomatic hyperlactatemia is frequent in patients who receive concomitant therapy for hepatitis C and HIV infection. Physicians should be aware of this potentially fatal complication, and a high index of suspicion is warranted in order to make an early diagnosis and therapy. |
| 104 | POSTPRANDIAL LIPIDEMIA DURING A PHYSIOLOGICAL CALORIC LOAD IN NON-CAUCASIAN HIGHLY ACTIVE ANTIRETROVIRAL THERAPY-TREATED HIV-POSITIVE PATIENTS Antiviral Therapy 2001 6(Supplement 4):69 (abstract no. 104) S Raghavan, J Albu, K Marshall, A Thomas, J Jones, T Schliep, M Littschwager, S Holleran, W Karmally, W El-Sadr and L Berglund Baseline metabolic characteristics showed a pronounced lowering of HDL-C and a modest hyper-TG. Following a physiologic caloric challenge, TG levels rose more slowly when compared to HIV-negative, insulin-resistant subjects. Thus, relationship to meals could appreciably affect TG results obtained by random blood sampling during HAART. |
| 105 | HEPATIC SIDE--EFFECTS OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY WITH EFAVIRENZ Antiviral Therapy 2001 6(Supplement 4):70 (abstract no. 105) B Roca and J García Hepatic toxicity of HAART with efavirenz seems unimportant; a mild increase in AP may occur. |
| 106 | METABOLIC SIDE-EFFECTS OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY WITH EFAVIRENZ Antiviral Therapy 2001 6(Supplement 4):70 (abstract no. 106) B Roca and J García Metabolic side-effects of HAART with efavirenz seem unimportant; a mild decrease in uric acid may occur. |
| 107 | PORPHYRIA CUTANEA TARDA INDUCED BY NELFINAVIR Antiviral Therapy 2001 6(Supplement 4):71 (abstract no. 107) B Roca, C Lapuebla and B Roig Porphyria cutanea tarda, a photosensitivity disorder due to uroporphyrinogen deficiency, may be induced by different drugs. We report a case of this illness provoked by a modality of highly active antiretroviral therapy. |
| 108 | INDINAVIR DOES NOT INCREASE MEAN TRIGLYCERIDE LEVELS IN HIV-INFECTED PATIENTS RECEIVING NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS Antiviral Therapy 2001 6(Supplement 4):71 (abstract no. 108) C Rojas1, PM Coplan2, T Rhodes2, MN Robertson2, MJ DiNubil2 and HA Guess1,2 Addition of indinavir to NRTI therapy was not associated with any further increment in mean non-fasting TG levels in three randomized trials of ART. |
| 109 | INFLUENCE OF NUTRITIONAL STATUS AND WEIGHT VARIATIONS ON THE PRESENTATION OF LIPODYSTROPHY IN HIV-INFECTED PATIENTS RECEIVING PROTEASE INHIBITORS Antiviral Therapy 2001 6(Supplement 4):72 (abstract no. 109) L Roudière, B Rakotoambinina, J Médioni, J-P Jais and J-P Viard Older age may influence the evolution to lipoatrophy. Low weight and cholesterol and high triglycerides, reflecting the hypercatabolic state of patients with uncontrolled HIV infection, seem to favour the occurrence of lipoatrophy. Higher weight and cholesterol, reflecting a preserved nutritional status, seem to favour the appearance of a mixed syndrome. Weight variations patterns on HAART could reflect a different response of adipocytes to PIs, depending on patients' nutritional status, at the initiation of these drugs. |
| 110 | ASSESSMENT OF THE IMPACT OF LIPODYSTROPHY ON THE QUALITY OF LIFE OF HIV-1- INFECTED PATIENTS Antiviral Therapy 2001 6(Supplement 4):73 (abstract no. 110) A Rousaud1, J Blanch2, E Martínez1, E De Lazzari4, J-M Peri2, A Milinkovic1, J-B Perez-Cuevas1, J-L Blanco3 and J-M Gatel3 The impact of HIV-related LD on QoL seems to be influenced by patients' characteristics, non-LD side-effects, and perception of certain body changes. |
| 111 | GROWTH HORMONE DOSE-RELATED SIDE-EFFECTS IN HIV/AIDS POPULATION; RETROSPECTIVE STUDY Antiviral Therapy 2001 6(Supplement 4):73 (abstract no. 111) G Santos, K Frend, F Sension, R Terrentine and S Wills In conclusion, given the high incidence of side-effects that we have observed with pharmacological doses of GH administered to HIV-positive patients with lipodystrophy, it would seem prudent to investigate more physiological doses (1 mg/day or less) of GH. These lower doses are known to be better tolerated and have been reported to reduce visceral adiposity in HIV-negative individuals. |
| 112 | DISTRIBUTION OF CARDIOVASCULAR RISK FACTORS IN FRENCH HIV- INFECTED MEN STARTED ON A PROTEASE INHIBITOR-CONTAINING REGIMEN COMPARED TO THE GENERAL POPULATION Antiviral Therapy 2001 6(Supplement 4):74 (abstract no. 112) M Savès1, G Chêne1, P Ducimetière2, C Leport3, G Le Moal4,P Amouyel5, D Arveiler6, J Ferrières7, J Reynes8, A Bingham2, F Raffi9, the French WHO MONICA Project, the APROCO (ANRS EP11) Study Group In HIV-positive men started on PI, the different distribution of CVR factors and increased coronary heart disease risk compared to general population require early detection; interventions should be evaluated in the global care of HIV patients. |
| 113 | A COMPARISON OF LIPID LEVELS ON RITONAVIR- OR DELAVIRDINE-CONTAINING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):74 (abstract no. 113) M Schutz and S Nangah We found our patients to have considerably lower cholesterol and triglyceride levels on a delavirdine-containing regimen compared to a ritonavir-containing regimen. This analysis is limited by small sample size, retrospective nature and the fact that lipid levels were not consistently obtained in a fasting state. Future studies should evaluate the potential of delavirdine-containing boosted PI regimens as an alternative to ritonavir boosting with less associated hyperlipidemias. |
| 114 | FACIAL IMPLANTS WITH POLYMETHYL-METHACRYLATE FOR LIPODISTROPHY CORRECTION: 30 MONTHS FOLLOW-UP Antiviral Therapy 2001 6(Supplement 4):75 (abstract no. 114) M Serra PMMA facial implants were shown to be safe, lasting, cost effective, very well tolerated, and with no side-effects when compared with temporary implants. The implants had a positive influence on patients' psychological status, recovering their self-esteem, and improving quality of life. |
| 115 | SUBCUTANEOUS INFILTRATION WITH PHOSPHATIDY/CHOLINE SOLUTION FOR TREATMENT OF 'BUFFALO HUMP' AND 'FATTY PADS' Antiviral Therapy 2001 6(Supplement 4):75 (abstract no. 115) M Serra1 and FB Pereira2 Phosphatidylcholine solution injections can be a promising simple and inexpensive treatment for fat accumulation in HIV patients, very well tolerated, and with excellent clinical and aesthetic results. |
| 116 | PROVIDER IDENTIFIED ADVERSE DRUG REACTIONS IN HIV PATIENTS: PREVALENCE AND CHARACTERIZATION Antiviral Therapy 2001 6(Supplement 4):76 (abstract no. 116) MJ Shelton, A Giovionello, S Ksiazek, S Rozek and RG Hewitt New onset ADRs were identified by providers during 8-12 % of clinic visits, although unidentified and unacknowledged ADRs were not addressed. Acute ADRs are more likely to be documented in medical records compared with chronic ADRs (ratio of 2:1 during both periods). Formalized ADR reporting systems should take into account acute versus chronic nature of ADRs in HIV patients and implemented to document ADRs in this population. |
| 117 | LIPODYSTROPHY SYNDROME IN 29 NAÏVE PATIENTS ON COMBINED ANTIRETROVIRAL THERAPY (HIGHLY ACTIVE ANTIRETROVIRAL THERAPY) IN GREECE Antiviral Therapy 2001 6(Supplement 4):77 (abstract no. 117) EC Siakavellas1, D Kiriake, N Sevastos1, V Paparizos3, A Filiotou1, N Stavrianeas3, A Kaloterakis1 and N Katsilabros2 The vast majority of patients responded successfully to therapy with significant amelioration in the evolution of HIV markers. However, appearance of the LS seems to be a constant side-effect in the vast majority of HIV-patients receiving antiretroviral treatment. |
| 118 | GASTROINTESTINAL TOXICITY AND TRIGLYCERIDE LEVELS WHEN SWITCHING FROM A TWICE DAILY TO A ONCE DAILY SAQUINAVIR SOFT GEL REGIMEN Antiviral Therapy 2001 6(Supplement 4):77 (abstract no. 118) P Srasuebkul1, P Cardiello1,2, E Hassink1,2, M Boyd1,3, T Manhapol1, A Hill4, K Ruxrungtham1, J Lange2, D Cooper3 and P Phanupak1 Overall GI toxicity on saquinavir SGC 1400 mg twice daily was comparable to toxicity after changing to sa quina vir SGC/ritonavir 1600/100 mg once daily. However, nausea and vomiting were significantly reduced on the once daily regimen despite addition of ritonavir and better saquinavir PK parameters. The reduction of nausea and vomiting may be due to less capmul ingestion on the once daily regimen. Increased saquinavir exposure on the once daily regimen did not cause a significant TG increase but this may be due small sample size and short follow-up period. Saquinavir SGC/ritonavir once daily, with less capmul, can decrease some GI toxicity without a significant short-term TG increases. |
| 119 | EFFECTS OF NUCLEOSIDE ANALOGUE REVERSE TRANSCRIPTASE INHIBITORS AND PROTEASE INHIBITORS ON BONE EXPLANTS IN VITRO Antiviral Therapy 2001 6(Supplement 4):78 (abstract no. 119) A Staal, MH French, LM Watson, VG Sasseville and JHM Feyen The NRTI stavudine does not show any direct effects on bone formation and bone resorption in our assays, which indicates that stavudine may not contribute directly to decreases in bone mineral density. However, zidovudine, ritonavir and indinavir demonstrated differential effects on bone formation and resorption. |
| 120 | ECTOPIC FAT ACCUMULATION IN THE LIVER IN HIGHLY ACTIVE ANTIRETROVIRAL THERAPY-ASSOCIATED LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):79 (abstract no. 120) J Sutinen1, A-M Häkkinen2, A Seppälä-Lindroos3, J Halavaara4, A Järvinen1, M Ristola1 and H Yki-Järvinen3 HAART lipodystrophy was not accompanied by increased ectopic hepatic fat content: as has been reported in insulin resistant mouse models with lipodystrophy. Striking visceral fat content was not accompanied by increase in hepatic fat. Fasting insulin concentration is determined by hepatic sensitivity to insulin in animal and human models of insulin resistance. A correlation between liver fat content and insulin concentration was found in HAART lipodystrophy, and their fasting insulin concentrations were higher than those of controls. These data imply that insulin resistance is more severe in HAART lipodystrophy than in normal subjects for a given amount of hepatic fat. |
| 121 | MORPHOLOGICAL MITOCHONDRIAL ALTERATIONS IN AN HIV-INFECTED PATIENT WITH SEVERE LACTIC ACIDOSIS AFTER TREATMENT WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY Antiviral Therapy 2001 6(Supplement 4):80 (abstract no. 121) M Tolomeo1, S Mancuso1, M Todaro2, G Stassi2, E Barbusca1, G Canonizzo1 and V Abbadessa1 Important morphological alterations in PBMC mitochondria can be observed during severe phases of HAART-induced hyperlactatemia. These alterations can persist for several weeks from therapy withdrawal. There is a correlation between hyperlactatemia, mitochondrial damage and apoptosis. Considering the important role of mitochondria in the apoptotic pathway, the increase of apoptosis in PBMC may be a consequence of pro-apoptotic factors released from altered mitochondria. |
| 122 | PRELIMINARY RESULTS OF A PATIENT-FILLED QUESTIONNAIRE ABOUT FACIAL LIPOATROPHY AND ITS REPAIR PROCEDURES IN FRANCE Antiviral Therapy 2001 6(Supplement 4):80 (abstract no. 122) E Trenado, T Prestel, H Gaigi and J Soletti These preliminary results suggest that the vast majority of responders have not had access to repair procedures but wish to do so. The ones who have undergone repair procedures are pleased with the results. The complete analysis of more than 200 questionnaires will be presented. |
| 123 | Rise in HDL-cholesterol associated with nevirapine-containing antiretroviral therapy in HIV-1- infected patients is sustained over 96 weeks of treatment Antiviral Therapy 2001 6(Supplement 4):81 (abstract no. 123) M van der Valk1, JJP Kastelein2, RL Murphy3, F van Leth1, C Katlama4, A Horban5, M Glesby6, G Behrens7, B Clotet8 and P Reiss1 on behalf of the Atlantic Study team The previously demonstrated increase of HDL-c in HIV-1-infected patients treated with a combination of stavudine, didanosine and nevirapine, was sustained through 96 weeks of therapy and is associated with a very favourable lipoprotein profile, known to lead to a reduced CAD risk. |
| 124 | USE OF PPAR-γ MODULATOR ROSIGLITAZONE IN NORMOGLYCEMIC PATIENTS WITH HIV LIPODYSTROPHY SYNDROME Antiviral Therapy 2001 6(Supplement 4):82 (abstract no. 124) F Visnegarwala and MR Maldonado The subjective improvement in the lipoatrophy and a trend towards improvement in the anthropomeric measurements seen in our small cohort of patients with the use of Rosiglitazone awaits confirmation in larger clinical trials. |
| 125 | INCREASED CAROTID INTIMA-MEDIA THICKNESS IN WOMEN WITH HIV LIPODYSTROPHY Antiviral Therapy 2001 6(Supplement 4):82 (abstract no. 125) S Wilkie1, R Chan2, R Lees2, M Sullivan1, C Hadigan1, S Grinspoon1 Further studies are needed to determine more definitively if HIV-infected women with lipodystrophy are at increased risk for CVD, such as stroke and myocardial infarction. |
| 126 | A SUBGROUP OF PROTEASE INHIBITOR TREATED HIV-1 PATIENTS SHOWS CLINICAL LIPOATROPHY BUT NOT ABDOMINAL OBESITY, HYPERLIPIDAEMIA OR GLUCOSE INTOLERANCE Antiviral Therapy 2001 6(Supplement 4):83 (abstract no. 126) D Worm1, O Kirk2, O Andersen2, J Vinten1, J Gerstoft3, T Katzenstein1, H Nielsen4 and C Pedersen5 Questionnaire and clinical examination can give concordant information on changes in body fat. Lipoatrophic patients may have side effects to protease inhibitor treatment, to nucleoside analogue treament or suffer from a drug independent condition. Lipoatrophy is not associated with increased plasma lipids or glucose intolerance. A common case definition of the syndromes of lipodystrohy is highly supported. |
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