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7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV13–16 November 2005, Dublin, Ireland |
BODY COMPOSITION CHANGES IN HIV-INFECTED PATIENTS WITH LIPOATROPHY 1 AND 2 YEARS AFTER SWITCHING FROM STAVUDINE TO TENOFOVIR DISOPROXIL FUMARATE
G Tsekes1, M Chini1, N Tsogas1, N Mangafas1, A Lioni1, I Salpigktis1, N Delikanakis2 and MC Lazanas1
1 3rd Department of Internal Medicine & Infectious Diseases Unit, Red Cross Hospital, Athens, Greece; 2 Department of Radiology, Red Cross Hospital, Athens, Greece
Antiviral Therapy 2005; Supplement 3:L26 (abstract no. 40)
BACKGROUND: Long-term use of stavudine in HIV-infected patients has been implicated in the development of lipoatrophy. Recent data suggest that there is a modest improvement in lipoatrophy one year after replacing stavudine with tenofovir disoproxil fumarate. However, it has not been investigated so far if this effect is maintained during the second year after switching.
OBJECTIVES: To determine body composition in a group of HIV-infected patients with clinically evident lipoatrophy 1 and 2 years after switching from stavudine to tenofovir.
METHODS: Ten HIV-infected patients (eight males, two females; age 43.8 ±6.0 years) with lipoatrophy were included in the study. All patients were receiving a stavudine- containing antiretroviral regimen for at least 1 year. Eight patients were also receiving a protease inhibitor and another nucleoside analogue; two patients were also receiving a non-nucleoside reverse transcriptase inhibitor and lamivudine. In all 10 patients stavudine was replaced by tenofovir, without other medication changes. The patients were assessed at baseline and weeks 48 and 96 by dual energy X-ray absorptiometry (DEXA). Bone mineral content (BMC), fat (FAT) and lean body mass (LEAN) were evaluated for whole body as well as regionally (arms, legs, trunk). Comparisons were made using paired t-tests.
RESULTS: Results (means ±SD) are shown in Table 1.
| Variable | Week 0 | Week 48 | Week 96 | P0–48 | P0–96 | P48–96 |
| Weight (kg) | 67.4±10.4 | 70.6±13.8 | 70.9±12.9 | 0.028 | 0.006 | 0.623 |
| BMC total (kg) | 2.8±4.4 | 2.8±4.7 | 2.8±4.8 | 0.874 | 0.482 | 0.445 |
| LEAN total (kg) | 54.2±7.1 | 53.9±7.7 | 53.7±6.7 | 0.581 | 0.441 | 0.635 |
| FAT total (kg) | 10.4±5.1 | 13.9±7.7 | 14.4±7.5 | 0.008 | 0.006 | 0.175 |
| Arms FAT (kg) | 0.9±0.8 | 1.3±1.1 | 1.2±1.0 | 0.067 | 0.219 | 0.648 |
| Legs FAT (kg) | 1.6±0.8 | 2.5±1.6 | 2.6±1.6 | 0.008 | 0.006 | 0.565 |
| Limb FAT (kg) | 2.5±1.4 | 3.8±2.5 | 3.8±2.4 | 0.014 | 0.021 | 0.869 |
| Trunk FAT (kg) | 7.5±3.9 | 9.6±5.4 | 10.2±5.3 | 0.007 | 0.005 | 0.106 |
CONCLUSIONS: In a group of HIV-infected individuals with lipoatrophy, replacing stavudine with tenofovir resulted in a modest but significant improvement in lipoatrophy after 48 weeks of treatment. The beneficial effect of switching on fat mass was maintained during the second year of treatment, but no further improvement was noticed.
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2005-11-13
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