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8th International Workshop on Adverse Drug Reactions
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Cite as: Antiviral Therapy 2006; 11(Supp. 3):Lx
where x is the page number
| Plenary Session |
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| P1 | ADIPOSE TISSUE AND INFLAMMATION Antiviral Therapy 2006; 11(Suppl. 3):L1 (abstract no. P1 K Clément This conference reviews the knowledge on inflammatory cytokines associated with adipose tissue and notably focuses on macrophage infiltration in human WAT, discussing their possible recruitment mechanism and role. The interactions of macrophages with adipocyte biology will certainly be the subject of intense investigations in the future and to some redefinition of the physiopathology of common metabolic diseases. |
| P2 | MECHANISMS OF DRUG INDUCED HEPATOTOXICITY Antiviral Therapy 2006; 11(Suppl. 3):L1 (abstract no. P2) M Peters Antiretroviral therapies may induce hepatotoxicity: some in a dose dependent manner; others more commonly in patients with viral hepatitis; and still others in an idiosyncratic manner. All classes of HAART have caused liver damage to a certain degree and the incidence is increased in patients with chronic hepatitis B or C. Large retrospective studies and a few prospective studies have evaluated the incidence of hepatotoxicity in patients on various regimens. In patients with pre-existing necroinflammatory liver disease, especially hepatitis B or C, HAART may be very difficult to manage but this talk will not address drug toxicity in viral hepatitis per se. |
| P3 | PHARMACOGENETIC APPROACHES IN THE TREATMENT OF OBESITY AND LIPID ABNORMALITIES Antiviral Therapy 2006; 11(Suppl. 3):L2 (abstract P3) W Siffert A variety of SNPs have been shown to predict pharmacokinetics and lipid changes under therapy with lipid lowering drugs, especially statins. The talk will give an introduction and overview of pharmacogenetics in the management of obesity and treatment of lipid abnormalities and discuss the hurdles that these new techniques will have to pass before routinely applied in clinical practices. |
| P4 | MECHANISMS OF INSULIN RESISTANCE: LESSONS LEARNED FROM CLINICAL STUDIES Antiviral Therapy 2006; 11(Suppl. 3):L2 (abstract P4) KF Petersen This plenary session will review the application of magnetic resonance (MR) techniques to examine the pathogenesis of insulin resistance and type 2 diabetes in humans.... |
| P5 | THE ‘METABOLIC SYNDROME’ AND CARDIOVASCULAR DISEASE: NEW INSIGHTS INTO MECHANISMS AND MANAGEMENT Antiviral Therapy 2006; 11(Suppl. 3):L2 (abstract P5) J Plutzky Ultimately, greater scientific insight into the metabolic syndrome and its origins, including its induction in response to anti-retroviral therapy, is needed in order to provide the rationale and basis for considering therapeutic approaches to preventing or treating this increasingly common problem. |
| Oral Abstracts | |
| Session I |
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| 1 | METABOLIC SYNDROME IN HIV-INFECTED PATIENTS USING IDF AND ATPIII CRITERIA: PREVALENCE, DISCORDANCE AND CLINICAL UTILITY Antiviral Therapy 2006; 11(Suppl. 3):L4 (abstract no. 1) K Samaras1,3, H Wand2, M Law2, S Emery2, DA Cooper2 and A Carr3 The prevalence of MS in this cohort of HIV+ adults by the IDF criteria was 14% and 18% by ATP III criteria. These rates are similar to those seen in the general population, but many subjects without MS, particularly those with lipodystrophy, had the metabolic (particularly lipid) aberrations of MS. The IDF and ATPIII definitions of MS may be insensitive tools for the maximal detection of cardiovascular and diabetic risk in HIV-infected adults. |
| 2 | METABOLIC SYNDROME, CARDIOVASCULAR DISEASE AND TYPE 2 DIABETES MELLITUS AFTER INITIATION OF ANTIRETROVIRAL THERAPY IN HIV-INFECTED ADULTS Antiviral Therapy 2006; 11(Suppl. 3):L4 (abstract no. 2) H Wand1, A Calmy2, D Carey1, K Samaras3, A Carr2, M Law1, D Cooper1,2 and S Emery1 Rapid and frequent progression to MS within 3 years of commencing initial ART regimens is associated with increased risk of CVD and T2DM. MS before ART was a stronger risk factor for development of CVD than incident MS. The presence of MS at ART initiation identifies individuals in whom preventive strategies should be considered. |
| 3 | INSULIN RESISTANCE IS INDEPENDENTLY ASSOCIATED WITH VAT AND UPPER TRUNK SAT IN CONTROLS AND HIV INFECTION Antiviral Therapy 2006; 11(Suppl. 3):L5 (abstract no. 3) C Grunfeld1, D Rimland2, C Gibert3, W Powderly4, S Sidney5, S Haffner6, M Shlipak1, S Heymsfield7 and R Scherzer1 When multiple adipose tissue depots are analysed, VAT and upper trunk SAT were independently associated with insulin resistance in controls even more so than in HIV+. These data suggest an expanded physiognomy associated with insulin resistance. |
| 4 | DEXA OUTCOMES IN ANTIRETROVIRAL-NAÏVE SUBJECTS RECEIVING NELFINAVIR OR EFAVIRENZ OR BOTH PLUS DUAL NUCLEOSIDES: LONG-TERM AS-TREATED RESULTS FROM A5005s Antiviral Therapy 2006; 11(Suppl. 3):L5 (abstract no. 4) MP Dubé1, L Komarow2, K Mulligan3, SK Grinspoon2, RA Parker2, GK Robbins2 and P Tebas4 Over 144 weeks, ZDV+3TC continued to be superior to ddI+d4T with regards to limb fat loss. The combination of ZDV+3TC+efavirenz had greater trunk fat increases, but showed no overall pattern suggesting limb fat loss over time and was significantly superior to the pooled ZDV+3TC+nelfinavir (with and without efavirenz) arms. |
| Session II | |
| Adipose tissue and inflammation |
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| 5 | A 6-MONTH ART INTERRUPTION IN HIV-INFECTED PATIENTS IMPROVES ADIPOSE TISSUE MORPHOLOGY: AND GENE EXPRESSION (ANRS EP29 LIPOSTOP) Antiviral Therapy 2006; 11(Suppl. 3):L6 (abstract no. 5) M Kim1, P Leclercq2, P Cervera1, E Lanoy3, M Maachi1,4, E Dorofeev3, L Slama5, MA Valentin6, D Costagliola3, A Lombes7, JP Bastard1,4 and J Capeau1,4 Stavudine and zidovudine were mainly involved in AT inflammation, which recovered after stopping these drugs. They also play a role in mitochondrial and differentiation alterations. PIs were also involved in differentiation and mitochondrial alterations although at different levels. These data clearly outline the deleterious impact of ART on adipose tissue with a prominent role for thymidine analogues. Since adipose functions recovered after a 6-month interruption, switch or treatment modifications strategies are justified. |
| 6 | ASSESSING THE RISK OF ADIPOSE TISSUE MITOCHONDRIAL TOXICITY IN HIV-INFECTED INDIVIDUALS ON CONTEMPORARY NRTI REGIMENS Antiviral Therapy 2006; 11(Suppl. 3):L6 (abstract no. 6) E Hammond, D Nolan, E McKinnon, C Pace and S Mallal Our study found no evidence of increased lipoatrophic risk for HIV infected patients initiating their first antiviral drug treatment with abacavir based therapies in the absence of stavudine or zidovudine. Changes in adipocyte mtDNA, adipose tissue cytokine expression and inflammation associated with stavudine (and zidovudine), independent of PI therapy use or HIV disease severity, indicate that changes in these parameters may underpin clinical lipoatrophy via a common pathogenic mechanism. |
| 7 | IRBESARTAN, AN ANGIOTENSIN II RECEPTOR I BLOCKER, PREVENTS THE ADVERSE EFFECTS OF HIV ANTIRETROVIRALS ON ADIPOCYTE FUNCTIONS Antiviral Therapy 2006; 11(Suppl. 3):L7 (abstract no. 7) F Boccara, M Caron, M Auclair and J Capeau Irbesartan can reverse the effects of protease inhibitors on lipid accumulation, differentiation and insulin signalling in murine adipose cell lines. The beneficial effect of IRB, particularly on insulin response, will be evaluated in vitro in human adipocytes treated with protease inhibitors. These results could benefit to HIV-infected patients with antiretroviral related lipodystrophy and insulin resistance. |
| 8 | TAKING KALETRA CAPSULES UP-REGULATES MONOCYTE/MACROPHAGE CD36 AND CELLULAR CHOLESTEROL: A 5 VOLUNTEER STUDY Antiviral Therapy 2006; 11(Suppl. 3):L7 (abstract no. 8) RN Greenberg1,2, MA Wilson2, H Vaughn2, T Guerin2, J White2 and EJ Smart2 Two weeks after stopping Kaletra, all increased levels were lower but not back to baseline. These results suggest that some HIV-1 PIs induce alterations in CD36 receptor-dependent uptake and efflux of cholesterol in macrophages/monocytes and thereby induce the subsequent accumulation of sterol in macrophages/monocytes. This accumulation of macrophage sterol may not be dependent on elevations in blood lipids. |
| Session III | |
| Mechanisms of Drug Induced Hepatotoxicity |
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| 9 | RISK OF HEPATOTOXICITY IN VIROLOGICALLY SUPPRESSED HIV PATIENTS SWITCHING TO NEVIRAPINE ACCORDING TO GENDER AND CD4 COUNT Antiviral Therapy 2006; 11(Suppl. 3):L8 (abstract no. 9) E De Lazzari, A León, JA Arnaiz, E Martinez, JM Mallolas, JL Blanco, M Laguno, M Larrousse, A Milinkovic, M Lonca and JM Gatell Contrary to naïve patients, virologically suppressed patients do not have a higher risk of hepatotoxicity or rash when stratified by gender and CD4 count. |
| 10 | URIDINE SUPPLEMENTATION WITH MITOCNOL ANTAGONIZES ZALCITABINE-INDUCED HEPATOTOXICITY IN MICE Antiviral Therapy 2006; 11(Suppl. 3):L8 (abstract no. 10) D Lebrecht, YA Vargas-Infante, B Setzer and UA Walker Zalcitabine induces steatothepatitic and fibrotic changes in murine liver. Despite relatively moderate levels of mtDNA depletion, there is a strong impairment of mtDNA-encoded respiratory chain function and upregulated ROS production. Mitocnol attenuates this mitochondrial hepatotoxicity without intrinsic effects. |
| 11 | MODIFICATION OF TRANSCRIPTIONAL ACTIVITY AND REGULATION DRIVES OSTEOBLAST RESPONSE TO HIV AND ITS TREATMENT IN VITRO Antiviral Therapy 2006; 11(Suppl. 3):L9 (abstract no. 11) EJ Cotter, N Chew, WG Powderly, PP Doran and AP Malizia This oral abstract is a combination of data presented within Posters 103 and 104. |
| 12 | PREVALENCE OF SECONDARY CAUSES OF OSTEOPOROSIS AMONG HIV INFECTED INDIVIDUALS Antiviral Therapy 2006; 11(Suppl. 3):L9 (abstract no. 12) G Guaraldi1, G Orlando1, N Squillace1, V Rochira2, B Madeo2, L Zirilli2, C Diazzi2, G Caffagni2, E Baraldi3, GC Carani2, R Esposito1 and P Tebas4 Although osteopenia/osteoporosis is very frequent among HIV infected individuals, secondary osteoporosis is relatively rare. Vitamin D deficiency (and secondary hyperparthyroidsm associated with it) is frequent in this Italian population and might be a contributor to this problem. The work up for secondary osteoporosis among HIV infected patients should include vitamin D levels, an assessment of renal function and total testosterone determinations. A more extensive work up is rarely useful and it should be reserved for the most severe cases. |
| Session IV | |
| Genetic Polymorphisms and Lipid Abnormalities |
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| 13 | A POLYMORPHISM IN THE RESISTIN GENE IS ASSOCIATED WITH EARLY ADVERSE METABOLIC OUTCOME AND PREDICTS FUTURE FAT LOSS ON HAART: PHARMACOGENETIC ASSOCIATION STUDY OF ACTG A5005s Antiviral Therapy 2006; 11(Suppl. 3):L10 (abstract no. 13) K Ranade1, R Parker1, O Flint1, R Parker2, P Tebas3, W Powderly4, S Grinspoon5, K Mulligan6, M Noor1 and M Dubé7 In this exploratory pharmacogenetic study, a single variant of the resistin gene was associated with the cluster of patients with adverse metabolic changes that also experienced greater limb fat loss on HAART. Confirmation in other cohorts and relationship to individual antiretroviral agents are required. |
| 14 | SCREENING FOR HLA-B*5701 REDUCES THE FREQUENCY OF ABACAVIR HYPERSENSITIVITY REACTIONS Antiviral Therapy 2006; 11(Suppl. 3):L11 (abstract no. 14) I Reeves, D Churchill and M Fisher HLA-B*5701 testing in this cohort has led to a significant reduction in the frequency of HSR in individuals treated with abacavir. The carriage frequency was as expected in persons of White ethnicity but higher than expected in those of Black ethnicity. The small numbers of Black patients in our sample make it difficult to comment on the utility of B*5701 testing in this group. We intend to investigate further the one individual with possible HSR by epicutaneous patch testing. |
| 15 | ACUTE EFFECTS OF HIV PROTEASE INHIBITORS IN THE FAILING HEART Antiviral Therapy 2006; 11(Suppl. 3):L11 (abstract no. 15) Q Yan, P Jay and P Hruz The PI atazanavir, which does not block GLUT4 activity, had no effect on myocardial glucose uptake or survival. These data suggest that acute PI-mediated GLUT4 blockade may adversely affect cardiac function in patients with pre-existing heart disease and/or those who develop cardiomyopathy. |
| 16 | EARLY CHANGES IN ADIPONECTIN AND LEPTIN LEVELS PREDICT CHANGES IN LIMB FAT MASS OVER 2 YEARS FOLLOWING INITIATION OF ANTIRETROVIRAL THERAPY Antiviral Therapy 2006; 11(Suppl. 3):L12 (abstract no. 16) A Calmy1, D Carey2, PW Mallon2, H Wand2, DA Cooper1,2, M Law2 and A Carr1 In ART-naïve individuals, early changes in adiponectin and leptin concentrations might assist in predicting long-term loss of limb fat. Both baseline BMI and leg fat mass were strong predictors of limb fat loss after 2 years of ART. |
| Session V | |
| Mechanisms of Insulin Resistance: Lessons Learned From Clinical Studies |
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| 17 | PREDICTORS OF CREATININE (CR) INCREASE AND DRUG DISCONTINUATION IN A PROVINCE-WIDE COHORT OF PATIENTS RECEIVING TENOFOVIR DF (TDF) Antiviral Therapy 2006; 11(Suppl. 3):L12 (abstract no. 17) M Harris1, R Joy2, N Zalunardo3, R Werb3, B Yip2, R Hogg2 and J Montaner2 Among patients taking TDF, Cr elevation and TDF discontinuation are associated with concomitant use of ddI but not boosted PIs. Cr increases and TDF discontinuation are also associated with more advanced HIV disease, as previously demonstrated. |
| 18 | SYSTEMATIC ERRORS IN ESTIMATING RENAL FUNCTION BY COCKCROFT-GAULT (CG) OR MODIFICATION OF DIET IN RENAL DISEASE (MDRD) EQUATIONS Antiviral Therapy 2006; 11(Suppl. 3):L13 (abstract no. 18) DP Kotler1, A Glyptis1, C Grunfeld2, M Pang2, ES Engelson1 and EM Sordillo1 CrCl is affected by nutritional status, specifically body cell mass, of which skeletal muscle is the largest component. Estimations of CrCl using height, weight, serum creatinine concentration, and demographics contain systematic errors related to nutritional status, which may lead to overestimation of CrCl in underweight or malnourished subjects and underestimation in obese subjects, with potential effects on drug safety and efficacy. |
| 19 | TENOFOVIR-ASSOCIATED RENAL INSUFFICIENCY IN HIV INFECTED WOMEN Antiviral Therapy 2006; 11(Suppl. 3):L13 (abstract no. 19) DW Lin1, M Gandhi1, P Bacchetti1, N Ameli1, A Pao1, S Buchbinder2, R Rodriguez1, R Greenblatt1 and KM Giacomini1 Our repeated measures random effects multivariate regression analysis demonstrated that tenofovir was associated with a statistically significant decline (7.86 ml/min) in eGFR (Table 1). eGFR declined over time during tenofovir therapy (Table 2). On average, the decline was sustained above 80 ml/min up to 42 months. This analysis suggests that among HIV-infected women, tenofovir is an important risk factor for renal insufficiency. |
| Session VI | |
| Review of New Drugs for Metabolic Disorders (Title TBC) |
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| 20 | URINARY PROTEOME ANALYSIS BY CAPILLARY ELECTROPHROESIS COUPLED MASS SPECTROMETRY (CE-MS) FOR DETECTION OF TENOFOVIR-ASSOCIATED KIDNEY DAMAGE IN HIV PATIENTS Antiviral Therapy 2006; 11(Suppl. 3):L14 (abstract no. 20) GMN Behrens1, U Moebius1, A Gurjanov1, H Mischak2, RE Schmidt1 and S Wittke2 Tenofovir therapy was associated with pathological urinary polypeptide patterns independent of pathological serum creatinin increase or reduced calculated creatinine clearance. CE-ME may aid in early diagnosis and discovery of the pathogenetic background of tenofovir-associated kidney damage. |
| 21 | IMPROVED TRIGLYCERIDES AND INSULIN SENSITIVITY WITH 3 MONTHS OF ACIPIMOX IN HIV-INFECTED PATIENTS WITH HYPERTRIGLYCERIDEMIA Antiviral Therapy 2006; 11(Suppl. 3):L14 (abstract no. 21) C Hadigan1, J Liebau1, M Torriani2, R Andersen1 and S Grinspoon1 Acipimox administration resulted in significant improvements in triglycerides, sustained reductions in lipolysis and improved glucose homeostasis in HIV infected individuals with hypertriglyceridemia. The improvement in overall metabolic profile with acipimox indicates an important potential clinical utility for this agent that requires further investigation. |
| 22 | EFFECTS OF LEPTIN TREATMENT ON GLUCOSE AND LIPID METABOLISM AND FAT DISTRIBUTION IN HIV-INFECTED PATIENTS WITH LIPOATROPHY AND HYPOLEPTINEMIA Antiviral Therapy 2006; 11(Suppl. 3):L15 (abstract no. 22) H Khatami1, K Mulligan1, J-M Schwarz1,2, GK Sakkas1, AM DePaoli3, S Park1, S Kim1, VW Tai1, M Wen1, GA Lee1, C Grunfeld1 and M Schambelan1 In this pilot study, leptin treatment was associated with improvements in insulin sensitivity in the liver but not in whole-body glucose uptake. Dyslipidemia improved. Visceral fat decreased with no apparent exacerbation of peripheral lipoatrophy, suggesting that leptin may have a depot-specific effect in adipose tissue. |
| 23 | EFFECT OF PIOGLITAZONE ON LIMB FAT AND CIRCULATING ADIPOKINES IN HIV-RELATED LIPODYSTROPHY (ANRS113: LIPIOT) Antiviral Therapy 2006; 11(Suppl. 3):L16 (abstract no. 23) M Maachi1,2, L Slama3, E Lanoy4, M-A Valantin5, A Chermak4, D William-Faltaos6, D Costagliola4, J Capeau1,2, W Rozenbaum3,7 and J-P Bastard1,2 Interestingly, this effect was observed both in patients not receiving and receiving stavudine. The delta change of limb fat mass between W0 and W48 correlated with both plasma pioglitazone concentration (r=0.476, P<0.001, n=51) and leptin variation between W0 and W48 (r=0.365, P<0.01, n=57). Overall, the results of this study support the use of pioglitazone in the treatment of peripheral lipoatrophy in HIV-1-infected patients. We report here that pioglitazone has a positive impact on limb fat and adipose tissue endocrine function by improving adipokines secretion. |
| 24 | EFFECTS OF A LIFESTYLE MODIFICATION PROGRAM IN HIV-INFECTED PATIENTS WITH THE METABOLIC SYNDROME Antiviral Therapy 2006; 11(Suppl. 3):L16 (abstract no. 24) K Fitch1, E Anderson2, J Hubbard2, S Carpenter1, W Waddell3, A Caliendo4 and S Grinspoon1 These data demonstrate that intensive lifestyle modification significantly improved important cardiovascular risk indices in HIV-infected patients with the metabolic syndrome. Lifestyle modification may be a useful strategy to decrease cardiovascular risk in this population. |
| POSTER PRESENTATIONS | |
| Body Composition |
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| 25 | BODY COMPOSITION CHANGES DURING PEGINTERFERON A PLUS RIBAVIRIN COMBINED THERAPY IN HCV-HIV COINFECTED PATIENTS Antiviral Therapy 2006; 11(Suppl. 3):L19 A Milinkovic, M Laguno, E de Lazzari, J Murillas, JL Blanco, A Leon, M Larrousse, E Martinez, M Lonca, S Vidal, JM Gatell and J Mallolas The HCV therapy leads to weight loss and decrease of peripheral fat, but these changes seems to be reversible to pre-treatment values after cessation of therapy. The type of peginterferon used could be related with greater transitory changes in weight and fat. |
| 26 | ASSOCIATION BETWEEN HEPATITIS C VIRUS COINFECTION AND REGIONAL ADIPOSE TISSUE VOLUME IN HIV-INFECTED MEN AND WOMEN Antiviral Therapy 2006; 11(Suppl. 3):L19 PC Tien1, P Bacchetti2, B Gripshover3, E Turner Overton4, D Rimland5 and D Kotler6 Our findings suggest that HIV/HCV coinfection is not associated with less subcutaneous adipose tissue in men or women. HCV infection mitigates the loss of leg fat seen in HIV-infected men on stavudine. |
| 27 | LONGITUDINAL ALTERATION IN BODY SHAPE AND METABOLISM ON NNRTI-HAART IN SOUTH INDIA Antiviral Therapy 2006; 11(Suppl. 3):L20 S Saghayam1, N Kumarasamy1, A Cecelia1, S Solomon1, P Balakrishnan1, G Shivaji2, T Flanigan3, K Mayer3 and C Wanke4 The initial 6 months response differed significantly from the follow-up 6 months response. The beneficial effect of NNRTI-HAART seen in the initial phase seems to be wearing off during the follow-up. Careful monitoring of these patients is warranted to prevent adverse effects of body shape and lipid changes with longer time on NNRTI. |
| 28 | THE PREVALENCE AND METABOLIC CONSEQUENCES OF ANTIRETROVIRAL-ASSOCIATED LIPODYSTROPHY IN A POPULATION OF HIV-INFECTED AFRICAN SUBJECTS Antiviral Therapy 2006; 11(Suppl. 3):L20 E Mutimura1, A Stewart2 and NJ Crowther3 Lipodystrophy is common in African subjects receiving HAART and is characterized by increased waist circumference and raised blood glucose and cholesterol concentrations. Glucose levels are also raised in non-lipodystrophic, HIV positive subjects suggesting that body fat re-distribution is not the major contributor to glucose intolerance in HAART-treated HIV positive patients. Thus, to prevent the progression of HIV-related metabolic complications to overt cardiovascular disease and T2DM risks in HIV positive individuals, there is a need to monitor anthropomorphic and metabolic parameters, mainly in countries where there are minimal health resources and HIV prevalence is highest in the world. |
| 29 | SWITCH FROM STAVUDINE (d4T) TO TENOFOVIR DF (TDF) IN COMBINATION WITH LAMIVUDINE (3TC) AND EFAVIRENZ (EFV) RESULTED IN CONTINUED VIROLOGICAL SUPPRESSION AND IMPROVEMENT IN LIPOATROPHY THROUGH 2 YEARS IN HIV-INFECTED PATIENTS Antiviral Therapy 2006; 11(Suppl. 3):L21 JVR Madruga1, I Cassetti2, JMAH Suleiman3, L Zhong4, J Enejosa4 and AK Cheng4 for the 903E Study Team In virologically suppressed patients, switching d4T to TDF in a once-daily regimen containing 3TC and EFV maintains virological suppression and provides continued CD4 cell increases through 2 years. Significant continued improvement in limb fat was observed. |
| 30 | BODY MASS CHANGE AND ANTHROPOMETRIC-RELATED ADVERSE EVENTS AT WEEK 24 IN TREATMENT-EXPERIENCED HIV-INFECTED PATIENTS RECEIVING TMC114/R OR CONTROL PIS IN POWER 1, 2 AND 3 Antiviral Therapy 2006; 11(Suppl. 3):L21 A Roberts1, J Hoy2, G Beatty3, T Vangeneugden4 and E Lefebvre5 No clinically relevant changes from baseline in BMI or waist and hip circumferences were observed in treatment-experienced patients receiving TMC114/r 600/100 mg bid. The incidence of AEs related to fat redistribution was low. Analysis of patients over a long-term follow up period of 96 weeks is ongoing. |
| 31 | MAGNETIC RESONANCE IMAGING (MRI) PROVIDES A PRECISE AND FAST TOOL TO QUANTIFY BODY SHAPE CHANGES OF HIV-1 INFECTED PATIENTS WITHOUT RADIATION Antiviral Therapy 2006; 11(Suppl. 3):L22 M Bickel1, J Eisen2, C Stephan1, T Lutz3, S Klauke4, V Jacobi2, S Zangos2 and S Staszewski1 The MRI provides a precise method with which several body regions, commonly affected by HIV associated lipodystrophy, can be objectively measured in a single, fast examination without the use of radiation. |
| 32 | BODY COMPOSITION CHANGES IN TREATMENT-EXPERIENCED HIV-INFECTED PATIENTS INITIATING AN ATAZANAVIR-CONTAINING ANTIRETROVIRAL REGIMEN Antiviral Therapy 2006; 11(Suppl. 3):L23 G Tsekes, M Chini, A Lioni, N Tsogas, N Mangafas, M Boboli and MC Lazanas In a group of treatment-experienced HIV-infected individuals, switching to atazanavir-containing antiretroviral regimens resulted in a significant increase in the total and trunk fat mass after 48 weeks of treatment; patients switching from d4T/AZT also exhibited an increase in the limb fat mass. |
| 33 | DIETARY INTAKE IN HIV-INFECTED MEN WITH LIPODYSTROPHY: RELATIONSHIPS WITH BODY COMPOSITION AND METABOLIC PARAMETERS Antiviral Therapy 2006; 11(Suppl. 3):L23 K Samaras1, H Wand2, M Law2, S Emery2, DA Cooper2,3 and A Carr3 In this population of lipoatrophic men, there was a strong, positive correlation between saturated fat intake and limb fat mass, but no relationship between nutrient intake and VAT or any lipid, glycaemic or adipokine parameter. Only interventional, prospective studies will determine whether any nutritional strategy can assist in ameliorating lipoatrophy or any of its associated metabolic complications. |
| 34 | EFFECTS OF ANTI-INFLAMMATORY THERAPY ON BODY COMPOSITION AND METABOLIC ALTERATIONS IN HIV LIPODYSTROPHY: A PILOT STUDY Antiviral Therapy 2006; 11(Suppl. 3):L24 G Ionescu1, S Reka2, JB Albu1, ES Engelson1 and DP Kotler1 Standard doses of trilisate are safe in HIVL, for a limited time. Therapy did not affect body composition, glucose disposal, or serum lipids. These results may be due to an inadequate salycilate level and subsequent lack of anti-inflammatory effect, as soluble TNF receptor levels did not change. However, fasting glucose concentration decreased significantly, which may be explained by decreased gluconeogenesis, a reported salicylate effect, rather than changes in insulin sensitivity. |
| 35 | PREVALENCE AND RISK FACTORS OF PUBIC LIPOMAS IN HIV-INFECTED PATIENTS Antiviral Therapy 2006; 11(Suppl. 3):L24 G Guaraldi1, G Orlando1, N Squillace1, A Roverato1, D De Fazio2, M Vandelli3, G Nardini1, B Beghetto1, M De Paola1 and R Esposito1 Both female sex and short HIV duration of therapy were considered to be proxy variables to BMI. A chain graph model was use to consider together risk factors for BH and PL. A non-null interaction between these two joint clinical picture was present which appear independent by the explicative variables, BMI and gender. PL prevalence is a clinical entity that needs to be included in the description of morphological alteration of LD. An unknown pathogenic mechanism common to BH and PL is hypothesized. |
| 36 | THE IMPACT OF HIV-ASSOCIATED ADIPOSE REDISTRIBUTION SYNDROME (HARS) ON HEALTH-RELATED QUALITY OF LIFE Antiviral Therapy 2006; 11(Suppl. 3):L25 RR Turner1, MA Testa2, M Su1, G Richmond3, N Muurahainen4, DP Kotler5 and M Thompson6 HARS substantially impacts several important HRQOL domains, as compared to 3 other chronic diseases. HARS has important consequences, especially for perceived health and mental and emotional functioning, which need to be considered as part of the treatment plan. |
| Adipocyte Biology |
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| 37 | LUMINEX CYTOKINE EXPRESSION ARRAY IN SUBCUTANEOUS FAT ADIPOCYTES, PREADIPOCYTES AND MACROPHAGES IN HIV-LIPOATROPHIC PATIENTS Antiviral Therapy 2006; 11(Suppl. 3):L25 DA Killebrew, CM Shikuma and M Gerschenson This technology will facilitate further analyses of cytokine expression in different cell components of fat tissue. |
| 38 | IMMUNE CELL/PRE-ADIPOCYTE INTERACTIONS INDUCE CYTOKINES WHICH ENHANCE ADIPOCYTE DIFFERENTIATION Antiviral Therapy 2006; 11(Suppl. 3):L25 D Lewis, J Couturier, C Horne and A Balasubramanyam These results suggest that mononuclear cells and preadipocytes chemically communicate and that such interactions can enhance fat differentiation. Such a mechanism might be involved in the accumulation of fat in HIV lipodystrophy. |
| 39 | TRANSCRIPT AND METABOLITE ANALYSIS OF THE EFFECTS OF HIV PROTEASE INHIBITORS IN MOUSE ADIPOCYTES REVEALS INHIBITION OF FATTY ACID SYNTHESIS AND A BIOCHEMICAL SIGNATURE OF ENERGY DEPLETION Antiviral Therapy 2006; 11(Suppl. 3):L26 OP Flint1, C Elosua1, RA Parker1, CM Hamilton2 and MA Noor1 PIs differentially down-regulate fatty acid gene expression and corresponding cellular metabolite concentrations as exemplified by decreases in palmitate, an end product of de novo lipogenesis. The latter may be related to differential blockade of glucose uptake by individual PIs. We conclude that several PIs can dysregulate adipocyte lipid metabolism at a fundamental molecular level by mechanisms that could contribute to the development of clinically relevant lipoatrophy. |
| 40 | ROSIGLITAZONE THERAPY MARKEDLY IMPROVES ADIPOCYTE RE-ESTERIFICATION IN HIV LIPODYSTROPHY SYNDROME Antiviral Therapy 2006; 11(Suppl. 3):L27 RV Sekhar1, S D’Amico1, K Rehman1, F Jahoor2, A Balasubramanyam1, J Shi1, S Patel1 and F Visnegarwala3 These data suggest that Rosiglitazone treatment of subjects with HIV lipodystrophy primarily increases adipocyte reesterification rate. However, this is offset by an increase in the rate of total lipolysis, and results in increasing FFA futile cycling. Despite the unchanged net lipolytic rate, the reduction in waist-to-hip ratio, and hip circumference strongly suggest that there is an overall effect toward fat retention in peripheral adipocytes with Rosiglitazone therapy. Rosiglitazone therapy could benefit patients with HIV lipodystrophy syndrome by increasing adipocyte reesterification, and result in improvement of peripheral lipoatrophy. |
| 41 | CELL DEATH IS PREDOMINANTLY SEEN IN PREADIPOCYTES OF HIV INFECTED SUBJECTS WITH OR WITHOUT LIPOATROPHY Antiviral Therapy 2006; 11(Suppl. 3):L27 GA McComsey1, M O‘Riordan1, J Ganz2, DE Libutti3, LE Gerschenson4, CA Kruse4, N Storer1, J JewettTennant1, S Goldman2 and M Gerschenson3 A similar high amount of cell death was seen in the fat of lipoatrophy subjects and ARV naïve subjects. Although the level of cell death negatively correlated with adipose tissue mtDNA levels, no correlation was found with limb fat. Cell death was mostly seen in the preadipocytes. Lastly, the lack of consistencies found between cell death by H&E and TUNEL generated apoptosis scores suggest the presence of other types of cell death besides apoptosis. Longitudinal follow up of these subjects with serial biopsies is ongoing. |
| 42 | TNFα AND LEPTIN ARE DECREASED IN HIV-ASSOCIATED LIPODYSTROPHY PATIENTS CLINICALLY AND DEXA FAT MASS RATIO DEFINED Antiviral Therapy 2006; 11(Suppl. 3):L28 P Freitas1, D Carvalho1, AC Santos2, R Marques3, AJ Madureira4, S Xerinda3, R Serrão3, C Gonçalves5, I Ramos4, H Barros2, A Mota-Miranda3 and JL Medina1 Leptin is decreased in lipodystrophic HIV patients indicating a reduction in subcutaneous fat mass; the hyperhomocysteinemia is a marker of increased cardiovascular risk; the TNFα levels had controversial date reports in these patients and they probably depend on the inflammatory state of this condition. |
| 43 | SERUM TOTAL GHRELIN ASSESSMENT IN HIV-1 INFECTED PATIENTS WITH AND WITHOUT ANTIRETROVIRAL DRUG TREATMENT Antiviral Therapy 2006; 11(Suppl. 3):L28 P Pinto-Marques1, P Marques-Vidal2, I Carvalho1, M Aguas1 and M Aleixo1 HIV-1 infection does not appear to influence total serum ghrelin circulating levels. HAART is associated with a trend to higher appetite scores and an increase in total serum ghrelin. |
| 44 | IMPAIRED GROWTH HORMONE SECRETION IN WOMEN WITH HIV-RELATED LIPODYSTROPHY Antiviral Therapy 2006; 11(Suppl. 3):L29 G Guaraldi1, G Orlando1, N Squillace1, V Rochira2, L Zirilli2, C Diazzi2, G Caffagni2, A Balestrieri2, ARM Granata2, MC De Santis3 and GC Carani2 Our data show that 37.5% of our patients had IGHS (12.5% – a severe IGHS, 25% – the mild form). The mean results ±SD of the three groups are displayed in Table 1. This study suggests that pituitary GH secretion may be impaired in HIV-infected women. The percentage of subjects with IGHS seems to be higher in HIV-infected women than in men (Koutkia 2005). IGF-1 results lower in IGHS subjects. Furthermore, body composition does not change according to GH-peak status. |
| 45 | INHIBITION OF RESISTIN DEGRADATION BY AN HIV PROTEASE INHIBITOR: A MECHANISM FOR METABOLIC ABNORMALITIES CAUSED BY HIGHLY ACTIVE ANTIRETROVIRAL THERAPY Antiviral Therapy 2006; 11(Suppl. 3):L29 WJ Geese, O Flint, R Parker, M Noor and K Ranade Taken together, these results provide a biochemical rationale for the genetic association between resistin and metabolic abnormalities caused by HAART, and provide new insight into resistin physiology. Furthermore, an assay of resistin cleavage could be developed to screen for anti-retrovirals that do not inhibit endogenous proteases that degrade resistin, and are thus less likely to perturb resistin levels. |
| 46 | LIPODYSTROPHIES LINKED TO HIV PROTEASE INHIBITOR THERAPY AND MUTATIONS IN A TYPE-LAMINS ARE BOTH ASSOCIATED WITH PRELAMIN A ACCUMULATION AND CELLULAR PREMATURE SENESCENCE Antiviral Therapy 2006; 11(Suppl. 3):L30 M Caron1, M Auclair1, B Donadille1, V Béréziat1, B Guerci2, M Laville3, H Narbonne4, C Bodemer5, O Lascols1,6, J Capeau1,7 and C Vigouroux1,7 In conclusion, both HIV-protease inhibitors (indinavir and nelfinavir) and LMNA mutations trigger premature cellular senescence in cultured fibroblasts, which could result from accumulation of prelamin A and/or mitochondrial dysfunction, evidenced in fibroblasts and adipose tissue. These alterations could participate in the pathophysiology of lipodystrophic syndromes linked to PI-treatment and LMNA mutations, and could lead to premature aging clinical complications. |
| Mitochondrial Disorders |
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| 47 | SUBCUTANEOUS ADIPOCYTE AND PRE-ADIPOCYTE ATP LEVELS ARE ASSOCIATED WITH THE ETIOLOGY OF HIV LIPOATROPHY Antiviral Therapy 2006; 11(Suppl. 3):L30 M Gerschenson, SL Steele, DE Libutti, C Milne, DC Chow and CM Shikuma This data demonstrates that the progression of HIV lipoatrophy includes alterations in ATP levels in adipocytes and preadipocytes. |
| 48 | EFFECT OF AZT ON THYMIDINE PHOSPHORYLATION IN CELL CULTURE Antiviral Therapy 2006; 11(Suppl. 3):L31 MD Lynx1,2, B Kang2 and EE McKee1,2 In contrast, the pro-drug AZT was shown to inhibit thymidine phosphorylation in all three lines with 50% inhibition concentrations (IC50) ranging from 4.4–21.9 µM. This suggests that AZT inhibits thymidine phosphorylation in cells expressing thymidine kinase 1 to the same degree as AZT inhibits thymidine kinase 2 in isolated mitochondria and the perfused rat heart. |
| 49 | MITOCHONDRIAL FUNCTION, MORPHOLOGY, AND METABOLIC PARAMETERS IMPROVE AFTER SWITCHING FROM A STAVUDINE- TO A TENOFOVIR-CONTAINING REGIMEN Antiviral Therapy 2006; 11(Suppl. 3):L32 C Kim1, R Murphy2, B Berzins2, J Weinstein3, J Shore2, B Da Silva4, E Belsey5 and M Gerschenson1 Fat mitochondrial function and morphology improved in adipose tissue of patients switched from d4T to TDF while remaining on Kaletra. Total cholesterol and glucose were decreased and trunk fat increased. This study suggests that switching from d4T to TDF results in improvement in fat mitochondria. |
| 50 | NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS IN MURINE AND HUMAN ADIPOCYTES: IMPACT ON MITOCHONDRIAL DNA DEPLETION AND RESPIRATORY CHAIN ACTIVITY Antiviral Therapy 2006; 11(Suppl. 3):L32 M Stankov, T Lücke, A Das, RE Schmidt and GMN Behrens Our results suggest that NRTI readily deplete mtDNA in murine adipocyte cell lines, human primary adipocyte cultures and in vivo. Depletion down to even 80–90% of the original conten, however, was not associated with impaired enzymatic activity of the respiratory chain complexes in murine and human adipocytes. |
| 51 | A PILOT STUDY OF CHIP-BASED WHOLE MITOCHONDRIAL GENOME SEQUENCING IN A SUBGROUP OF PARTICIPANTS FROM AIDS CLINICAL TRIALS GROUP (ACTG) STUDY 384 Antiviral Therapy 2006; 11(Suppl. 3):L33 T Hulgan1, JL McCauley1, AA Motsinger1, DW Haas1, S Levy1, CB Sutcliffe1, DG Murdock1, GK Robbins2, DB Clifford3 and JA Canter1 for the NWCS 256 Team Chip-based whole mtDNA sequencing is technically feasible, was able to accurately haplogroup these HIV-infected individuals, and identified several known and potentially novel SNPs. In this small sample, the initial 7 mtDNA SNPs explored were not associated with NRTI-associated peripheral neuropathy. This technology could accelerate investigations into genetic predictors of antiretroviral toxicities, and may eventually be useful for clinical screening and risk stratification. |
| 52 | MITOCHONDRIAL TOXICITY OF NUCLEOSIDE ANALOGUE COMBINATIONS CURRENTLY USED IN TREATMENT OF HIV: IN VITRO STUDIES IN HUMAN HEPATOMA CELL LINES Antiviral Therapy 2006; 11(Suppl. 3):L33 OP Flint, A Bellamine, R Mulvey, C Elosua and MA Noor Consistent we previous reports, we confirm that the NRTIs in current clinical use differentially reduce cell mtDNA content in hepatocytes in vitro, however, the inhibitory effect of combination agents is additive, not synergistic. |
| 53 | EFFECTS OF NRTI-SPARING AND NRTI-CONTAING REGIMENS ON MITOCHONDRIAL/NUCLEAR (mt/n) DNA RATIOS Antiviral Therapy 2006; 11(Suppl. 3):L34 M Harris1, H Cote2, A Thorne1, I Gadawski2, C Ochoa3, C Allavena4, P Cahn3, C Zala3, F Raffi4, F Smaill5, B Trottier6, E Negredo7, B Clotet7, J Singer1, J Montaner1 and the CTN 177 study team Forty-eight weeks of treatment with either NVP/LPV/r or regimens containing AZT/3TC did not affect mitochondrial/nuclear DNA ratios in antiretroviralnaïve adults and no differences were observed between treatment arms. These results should be interpreted with caution in view of the small number in each group. This combination of NRTIs appears to have minimal impact on mitochondrial DNA levels in peripheral blood, but may affect other parameters. Changes in mitochondrial RNA levels will be reported. |
| 54 | MITOCHONDRIAL DYSFUNCTION IN HAART: MEASUREMENT OF KEY OXPHOS ENZYMES WITH SIMPLE DIPSTICK IMMUNOASSAYS Antiviral Therapy 2006; 11(Suppl. 3):L35 MF Marusich1,2, J Willis1 and RA Capaldi1,2 OXPHOS dipstick analysis of these samples is extremely reliable and simple, providing a platform with great potential for routine, repetitive clinical application, potentially suitable for use at point of care, even in resource-poor settings. In summary, the tests are useful research tools to study the metabolic complications of HAART and may serve as theranostic aids to help guide HAART. |
| Insulin Resistance |
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| 55 | CHANGES IN GLUCOSE METABOLISM, LIPOLYSIS AND FAT DISTRIBUTION BETWEEN 3 AND 12 MONTHS AFTER THERAPY INITIATION IN ANTIRETROVIRAL-NAÏVE HIV-1-INFECTED MEN RANDOMIZED TO ZIDOVUDINE/3TC/LOPINAVIR/R OR NEVIRAPINE/LOPINAVIR/R (MEDICLAS – METABOLIC EFFECTS OF DIFFERENT CLASSES OF ANTIRETROVIRALS) Antiviral Therapy 2006; 11(Suppl. 3):L35 MGA van Vonderen1, RME Blümer2, E Hassink3, J Sutinen4, MT Ackermans2, MA van Agtmael1, H Yki-Jarvinen4, SA Danner1, P Reiss2,3 and HP Sauerwein2 (on behalf of the MEDICLAS study group) At month 12 patients on LPV/r/AZT/3TC had developed decreased insulin sensitivity at the level of lipolysis, with no further deterioration of the reduction in insulin sensitivity at the level of peripheral glucose disposal observed earlier at 3 months. In contrast, in patients on LPV/r/NVP, in spite of a generalized increase in fat mass, insulin sensitivity which had not changed after 3 months remained unchanged out to 12 months. The increase in limb fat in patients on LPV/r/NVP was not observed in those on LPV/r/AZT/3TC. Whether these latter patients will develop peripheral lipoatrophy remains to be demonstrated during further follow-up. |
| 56 | ANTECEDENT EXERCISE IMPROVES GLUCOSE UTILIZATION IN HEALTHY VOLUNTEERS TREATED WITH A SINGLE DOSE OF PROTEASE INHIBITOR Antiviral Therapy 2006; 11(Suppl. 3):L36 DA Doran1, SP Jones2, L Evans3, IT Campbell3, DJ Stokes1, AP Yates4, M Pirmohamed2, DJ Back2, SH Khoo2 and DPM MacLaren1 Given the purported effects of most PIs on glucose disposal it may be beneficial to consider physical activity as an adjunct to more traditional pharmacological and dietary interventions in regulating glucose homeostasis. Further investigation of the mechanisms by which exercise modulates improvements in glucose homeostasis in individuals’ adherent to protease inhibitor regimen is warranted. |
| 57 | IMPROVEMENT IN INSULIN SENSITIVITY AND DYSLIPIDEMIA IN PROTEASE INHIBITOR-TREATED PATIENTS AFTER SWITCH TO ATAZANAVIR/RITONAVIR (ATV/RTV): A PROSPECTIVE STUDY USING HYPERINSULINEMIC, EUGLYCAEMIC CLAMP TESTING Antiviral Therapy 2006; 11(Suppl. 3):L37 AJ Busti1, R Bedimo2, D Margolis3 and D Hardin4 In the first study using the gold-standard euglycaemic clamp, ATV/RTV improved PI-induced insulin resistance among dyslipidemic HIV+ patients on PI-based HAART. These findings are not attributable to a change in body weight and provide direct evidence for ATV’s unique metabolic profile among the PIs. |
| 58 | METABOLIC AND ANTHROPOMETRIC ALTERATIONS IN A POPULATION OF HIV INFECTED PATIENTS WITH A HIGH PREVALENCE OF LIPODYSTROPHY: ASSOCIATIONS WITH HCV COINFECTION Antiviral Therapy 2006; 11(Suppl. 3):L37 N Squillace1, G Lapadula2, G Orlando1, G Nardini1, B Beghetto1, C Torti2 and G Guaraldi1 Our data confirm that HCV coinfection is an independent risk factor for insulin resistance in a large well-defined HIV cohort (mainly lipodystrophic patients). Several potentially modifiable factors are correlated with insulin resistance, such as hypertriglyceridemia, exposure to thymidine analogue drugs, overweight and sedentary life style. These findings may promote specific counselling interventions, which should be targeted particularly to HCV-coinfected patients. |
| 59 | HYPERTRIGLYCERIDEMIA IN HIV PATIENTS ON HAART IS NOT INVERSELY RELATED TO HDL CHOLESTEROL: A UNIQUE FEATURE OF THIS SYNDROME OF INSULIN RESISTANCE Antiviral Therapy 2006; 11(Suppl. 3):L38 S Kamble, E Chang, H Pownall and A Balasubramanyam Unlike other common syndromes of insulin resistance, the hyper-VLDL-triglyceridemia that is characteristic of HIV patients on HAART does not bear an inverse relationship to HDL cholesterol. This suggests that CETP activity may not be significantly increased in patients with HIV/HAART-associated dyslipidemia, and that hyper-VLDL-triglyceridemia is not predominantly a consequence of insulin resistance in this condition. Effects of HAART agents or the HIV virus itself on adipocyte or liver metabolism may be primarily responsible for hypertriglyceridemia in HIV patients on HAART. |
| 60 | EXERCISE TRAINING IMPROVES GLUCOSE UPTAKE IN MICE TREATED SIMULTANEOUSLY WITH TWICE DAILY RITONAVIR Antiviral Therapy 2006; 11(Suppl. 3):L38 DA Doran1, Qingyun Yan3, H Struthers2 and PW Hruz2,3 We conclude that 4 weeks of exercise training improves the Rg of 2-DG in PI treated mice compared to their non-exercising littermates. Whilst exercise may improve glucose uptake relative to that observed in a non exercise condition, it may not normalise it. Tissue specific differences in Rg are apparent that likely reflect differences in muscle fiber type and predominant GLUT isoform expressed. |
| 61 | PERIPHERAL GLUCOSE DISPOSAL IS NOT ACUTELY ALTERED BY TIPRANAVIR Antiviral Therapy 2006; 11(Suppl. 3):L39 P Hruz and Q Yan The lack of direct effects on glucose uptake supports the role of the peptidomimetic structure found in other PIs in mediating GLUT4 blockade. These data further indicate that, similar to atazanavir, tipranavir will not directly contribute to the development of insulin resistance in treated patients. |
| 62 | SINGLE DOSE ATAZANAVIR BOOSTED WITH RITONAVIR DOES NOT INDUCE INSULIN RESISTANCE IN HEALTHY VOLUNTEERS Antiviral Therapy 2006; 11(Suppl. 3):L39 DA Doran1, SP Jones2,5, L Evans3, IT Campbell3, DJ Stokes1, AP Yates4, M Pirmohamed2, DJ Back2, SH Khoo2 and DPM MacLaren1 It is likely that the ∼34% reduction in glucose utilization under the IDV/r condition is a function of IDV rather than the low-dose ritonavir, although synergism between the IDV and ritonavir cannot be excluded. |
| 63 | CANDIDATE HUMAN MUSCLE PROTEIN BIOMARKERS INVOLVED IN THE PATHOGENESIS OF HIV+ INSULIN RESISTANCE: A MASS SPECTROMETRY-BASED PROTEOMICS STUDY Antiviral Therapy 2006; 11(Suppl. 3):L40 KE Yarasheski, H Rohrs, S Smith, AJ Becker, LY Munsell and RR Townsend With replication, these differentially expressed protein forms represent candidate biomarkers for HIV+ insulin resistance. Several protein forms suggest that the pathogenesis of HIV+ insulin resistance is associated with upregulation of antioxidant protein expression, and defects or downregulation of several novel glucose and fatty acid metabolism pathways that may represent potential therapeutic targets. |
| Lipid Metabolism |
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| 64 | EFFECT OF PROTEASE INHIBITOR-BASED ANTIRETROVIRAL THERAPY ON LIPID METABOLISM AND LACTATE LEVELS IN PREGNANCY (ACTG A5084) Antiviral Therapy 2006; 11(Suppl. 3):L40 EG Livingston1, SE Cohn2, Y Yang3, JW Andersen3, DH Watts4, AD Bardeguez5, TB Jones6, LM Stevens7 and GA McComsey8 for the ACTG A5084 team Expected elevations of TC and TGC due to pregnancy were observed in both groups and declined after delivery. Fasting TC and TGC were higher in protease inhibitor treated patients in pregnancy. Increased LPD levels did not affect pregnancy outcome, but long term significance is unclear. LAC levels, even the few that were slightly increased, appeared to have little impact on the subjects’ clinical course. |
| 65 | INDINAVIR EXPOSURE DECREASES LIVER STEAROYL-CoA DESATURASE-1 GENE EXPRESSION IN ZUCKER FA/FA RATS Antiviral Therapy 2006; 11(Suppl. 3):L41 MJ Carper, KE Yarasheski, S Zhang, S Smith, A Bohrer and S Ramanadham We propose that prolonged in vivo exposure to IDV, and potentially other PIs, may disrupt insulin signalling by inhibiting SCD-1 expression, which can reduce conversion of 16:0 to 16:1, increase 16:0 accumulation in diglyceride pools, and adversely alter lipid composition in insulin sensitive tissues. |
| 66 | MORE INSIGHT INTO THE INFLUENCE OF HIV AND ANTIRETROVIRALS ON LIPID CHANGES Antiviral Therapy 2006; 11(Suppl. 3):L42 S Mauss1, F Berger1, C Athmann1, G Schmutz1 and WO Richter2 As advanced HIV infection raises triglycerides the inverse correlation between triglycerides at baseline and changes at week 24 of treatment suggests a compensating effect of antiretrovirals on a HIV induced rise in triglycerides. Most patients 68/82 (83%) showed a low HDL (<1 mmol/l). The strong effect of HIV on HDL may explain the increase of HDL in the vast majority of patients. |
| 67 | IMPROVEMENTS IN LIPID PROFILE IN HIV-1-INFECTED WOMEN FOLLOWING SUBSTITUTION OF A SINGLE NRTI BY TENOFOVIR DF (48-WEEK DATA FROM LIPOREC STUDY) Antiviral Therapy 2006; 11(Suppl. 3):L42 MJ Galindo1, C Miralles2, MJ Pérez-Elías3, R Palacios4, P Arazo5, MI Ruíz6, I Ocaña6, R Sánchez-de la Rosa7, S Moreno3 and the RECOVER Study Group An improvement in lipid profile has also been observed in women after a switching of NRTI by TDF because of toxicity. This strategy can be safe and useful in women with dyslipidemia related or not with NRTI. |
| 68 | LIPOPROTEIN (A) IS INCREASED BY ANTIRETROVIRAL THERAPY Antiviral Therapy 2006; 11(Suppl. 3):L43 S Mauss1, F Berger1, C Athmann1, G Schmutz1 and WO Richter2 A substantial increase in lp(a) concentration was mainly restricted to patients with high lp(a) at baseline. This may have clinical implications as patients with high lp(a) are at higher risk for myocardial infarction and stroke. In addition the lp(a) increase under antiretroviral therapy is remarkable, because only minor changes have been observed so far in the general population due to diet, life style modification or medical intervention. Lp(a) should be included in studies assessing the influence of HIV and antiretrovirals on cardiovascular risk as it may represent not only a risk factor per se but may be modified unfavourably by antiretroviral therapy. |
| 69 | DIFFERENTIAL EFFECTS OF NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTI) WITH AND WITHOUT A PROTEASE INHIBITOR (PI) OR NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR (NNRTI) ON LIPID PARAMETERS Antiviral Therapy 2006; 11(Suppl. 3):L43 DH Sutherland-Phillips, JE Hernandez, PG Wannamaker, LP Dix, T Vila and MS Shaefer The median lipid change from BL to W48 was comparable among patients receiving NRTIs with NFV or EFV (TC, LDL-C, and TGs) with a higher increase in HDLC in the EFV groups. Independent of NFV or EFV effects, COM + ABC had the most favorable lipid profile with most of the increase in TC driven by HDL-C. The similarity in lipid elevations with EPZ/EFV and TZV/EFV suggest that EFV is driving these elevations with a minimal effect of ZDV. The triple regimen d4T/3TC/NFV had the largest increases in TC, LDL-C and TGs. |
| 70 | CORONARY RISK BY INTERMEDIATE-DENSITY LIPOPROTEINS (IDL) IN HIV-INFECTED SUBJECTS ON ANTIRETROVIRAL THERAPY Antiviral Therapy 2006; 11(Suppl. 3):L44 S Mauss1, F Berger1, G Schmutz1 and WO Richter2 Treatment with PI or NRTI does not generally increase the concentration of IDL-cholesterol, IDL-triglycerides, or IDL-apolipoprotein B-100. Yet, 4 patients on NRTI (3 of 10) or atazanavir (1 of 6) had increased IDL which may be associated with an increased risk for coronary heart disease. No patient on lopinavir/ritonavir had increased IDL. The cause why some patients show increased IDL remains to be established. |
| 71 | HIGH PREVALENCE OF FAT REDISTRIBUTION AND LIPID METABOLISM ABNORMALITIES IN A GROUP OF ADOLESCENTS WITH GOOD IMMUNOLOGICAL AND VIROLOGICAL RESPONSE TO HAART Antiviral Therapy 2006; 11(Suppl. 3):L45 L Ene, D Duiculescu and R Radoi High prevalence of fat distribution changes and lipid abnormalities was found in our group of adolescents with DOT. Lipid metabolism abnormalities were related to prolonged exposure to ART (especially ddI, d4T or PI). Altered HDL but not LDL levels were encountered in one quarter of the adolescents from our group and were associated with physical changes, consequently raising the issue of high cardiovascular risk. |
| 72 | EVOLUTION OF LIPID ABNORMALITIES IN HORIZONTALLY HIV INFECTED CHILDREN Antiviral Therapy 2006; 11(Suppl. 3):L44 ML Draganescu, CM Pintilie, N Cireasa and T Radu Metabolic complications are frequent in children. The most frequent abnormality is low HDL-cholesterol, high triglycerides are unusual in children.The prevalence of lipid abnormalities is lower at 48 weeks than baseline. Conversion to normal lipid profile is correlated only with the efficacy of HAART whatever ARV is used. |
| Cardiovascular Disease |
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| 73 | HOMOCYSTEINE LEVEL IS NOT A GOOD MARKER OF CARDIOVASCULAR RISK IN HIV INFECTED CHILDREN: A STUDY OF CARDIOVASCULAR MARKERS AND CAROTID ULTRASOUND Antiviral Therapy 2006; 11(Suppl. 3):L46 GA McComsey1, M O’Riordan1, DE El Bejjani2, N Storer1, S Bhatt3 and V Dogra3 Surprisingly, despite multiple cardiovascular risk factors, a higher carotid IMT and HS-CRP, lower homocysteine levels were found in ART treated HIV+ children when compared to matched healthy controls. This suggests that homocysteine levels may not be a good marker of cardiovascular risk in this population. |
| 74 | WAIST CIRCUMFERENCE: DESCRIPTIVE ANALYSIS AND ASSOCIATION WITH RELATED METABOLIC PARAMETERS IN A COHORT OF TREATED HIV-INFECTED MALES Antiviral Therapy 2006; 11(Suppl. 3):L46 J Falutz and L Rosenthall We demonstrate a significant association between WC and relevant metabolic parameters in a large cohort of treated HIV(+) males. These parameters are acknowledged independent CVD risk factors. Measuring the WC may be a simple means of identifying those pts in whom appropriate interventions to decrease CVD risk may need to be instituted. |
| 75 | COMPARATIVE ASSESSMENT OF CHANGES IN BLOOD PRESSURE (BP) THROUGH 48-WEEKS FROM A PHASE III CLINICAL TRIAL OF LOPINAVIR/RITONAVIR (LPV/r) Antiviral Therapy 2006; 11(Suppl. 3):L47 BA da Silva, M King, RA Rode, C Kelly and GJ Hanna Neither LPV/r nor NFV cause clinically significant changes in BP through 48 weeks of treatment. Specifically, no increases in DBP were observed. A small mean increase of uncertain clinical significance in average SBP was noted for both LPV/r and NFV through 48 weeks. No clinically significant shifts between baseline and final visit based on JNC criteria were observed. These findings do not support a differential effect of LPV/r on BP compared to NFV. |
| 76 | PRO-ATHEROGENIC RISK ASSESSMENT BY NMR LIPOPROTEIN SUBCLASS ANALYSIS IN HIV-INFECTED PATIENTS NAÏVE TO ANTI-RETROVIRAL THERAPY Antiviral Therapy 2006; 11(Suppl. 3):L47 AP Liappis, NJ Bisby, SZ Schuck, AA Desrosiers, V Paliouras, AG Wasserman, AD Roberts, DM Parenti and GL Simon The consideration of baseline PAR may assist providers when making anti-retroviral choices. The atherogenic risk potential of naïve HIV-infected patients may be greater than predicted by traditional cholesterol parameters. This may be particularly true in the case of men with untreated HIV-infection. The development potential of HIV-associated CVD may be assessed more accurately by measuring lipoprotein subclasses. |
| Clinical Management |
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| 77 | COMBINATION ANTIRETROVIRAL THERAPY WITHOUT A NUCLEOSIDE ANALOGUE LEADS TO INCREASE LIPID LEVELS: EXPERIENCE FROM 334 PATIENTS IN THREE COHORTS Antiviral Therapy 2006; 11(Suppl. 3):L48 A Calmy1, K Petoumenos2, C Lewden3,4, Matthew Law2, F Bocquentin4, K Hesse1, D Cooper1,2, A Carr1 and F Bonnet2,3,4 for the Aquitaine Cohort, the Australian HIV observational Database and the Saint-Vincent’s Hospital Cohort* In these antiretroviral-experienced patients, NRTI-sparing therapy appeared to have satisfactory virological and immunological efficacy. However, hyperlipidemia was frequent and requires monitoring of cardiovascular risk-factors. |
| 78 | IMPROVEMENT IN LIPID PROFILE IN HIV-INFECTED VIROLOGICALLY CONTROLLED PATIENTS SWITCHED TO A SIMPLE QD REGIMEN: RESULTS OF THE COOL TRIAL EVALUATING EFV/TDF VERSUS EFV/TDF/3TC Antiviral Therapy 2006; 11(Suppl. 3):L48 P Mercié1, A Trylesinski2, A Cabié3, C Michelet4, R Verdon5, C Katlama6, L Weiss7, O Caubet8, D Sereni9, M Bentata10, J Durant1, A Simon6, L Morand-Joubert12, G Chêne13, P Pétour2 and PM Girard12 The virological efficacy of the 2-drug arm was inferior to 3-drug arm. Virological control was maintained in all patients of the 3-drug arm. Lipid and biological parameters improvement was observed switching from BID HAART to QD TDF based HAART. |
| 79 | LIPID PROFILES IN ANTIRETROVIRAL-NAÏVE HIV-1-INFECTED SUBJECTS ON ONCE-DAILY ABACAVIR/LAMIVUDINE (ABC/3TC) + RITONAVIR-BOOSTED ATAZANAVIR (ATZ/R): 24-WEEK ANALYSIS FROM COL102060 (SHARE) Antiviral Therapy 2006; 11(Suppl. 3):L49 R Elion1, E DeJesus2, M Sension3, D Berger4, W Towner5, G Richmond6, L Yau7 and B Ha7 for the COL102060 study team While a high rate of virological suppression was observed with this regimen, the use of low-dose RTV with ATV appeared to increase development of hyperlipidemia, in particular, hypertriglyceridemia. |
| 80 | A RANDOMIZED OPEN-LABEL STUDY COMPARING THE IMPACT OF REDUCING THE DOSE OF STAVUDINE VERSUS SWITCHING TO TENOFOVIR ON PLASMA LIPIDS, BODY COMPOSITION AND MITOCHONDRIAL FUNCTION IN HIV-INFECTED PATIENTS: RESULTS AT 48 WEEKS Antiviral Therapy 2006; 11(Suppl. 3):L49 A Milinkovic, E Martinez, E de Lazzari, S López, O Miro, S Vidal, J Fernández, JL Blanco, M Laguno, JA Arnaiz , A Leon, M Larrousse, M Lonca, J Mallolas and JM Gatell Both strategies were associated with trend toward a decrease in plasma lipids and an improvement of peripheral lipoatrophy that remained significant at 48 weeks only after switching to tenofovir. The observed loss of lean mass in tenofovir arm may be potentially attributed to limitations of DEXA to measure intramuscular fat content. |
| 81 | SIGNIFICANT IMPROVEMENTS IN SELF-REPORTED GASTROINTESTINAL TOLERABILITY, QUALITY OF LIFE (QoL), PATIENT SATISFACTION, AND ADHERENCE WITH LOPINAVIR/RITONAVIR (LPV/r) AFTER SWITCHING FROM BID SOFT-GEL CAPSULE (SGC) TO BID TABLETS Antiviral Therapy 2006; 11(Suppl. 3):L50 S Schrader1, SK Chuck2, LW Rahn2, KG Emrich2 and PS Parekh2 In this survey of 332 HIV-infected patients, significant improvements in gastrointestinal AEs, satisfaction, tolerability, and adherence were reported when patients switched from LPV/r SGC to tablets. The tablet benefit most frequently ‘liked’ by respondents was lack of refrigeration. These results suggest that LPV/r tablets provide multiple benefits to HIV patients relative to SGC. Additional study to further define the tolerability profile of LPV/r tablet is warranted. |
| 82 | THE SAFETY AND EFFICACY OF TENOFOVIR DF (TDF) IN COMBINATION WITH LAMIVUDINE (3TC) AND EFAVIRENZ (EFV) THROUGH 5 YEARS IN ANTIRETROVIRAL-NAÏVE PATIENTS Antiviral Therapy 2006; 11(Suppl. 3):82 I Cassetti1, JVR Madruga2, JMAH Suleiman3, L Zhong4, J Enejosa4 and AK Cheng4 for the 903E Study Team Through 5 years of therapy, TDF+3TC+EFV demonstrated sustained antiretroviral activity with continued immunologic recovery and was not associated with limb fat loss or renal adverse events in antiretroviral-naïve patients. |
| 83 | SWITCHING TO LOPINAVIR/RITONAVIR (LPV/r) TABLET ONCE DAILY (TAB-QD) FROM SOFT-GEL CAPSULE DOSED BID/QD (SGC-BID/SGC-QD) LED TO SIGNIFICANT IMPROVEMENTS IN TOLERABILITY, DIARRHEA, ANTIDIARRHEAL MEDICATION USE, AND SATISFACTION Antiviral Therapy 2006; 11(Suppl. 3):L51 S Schrader1, SK Chuck2, LW Rahn2, KG Emrich2 and PS Parekh2 This survey of 41 HIV-infected patients switched from LPV/r SGC to TAB-QD noted significant improvements in tolerability, diarrhea occurrence, antidiarrheal medication use, and satisfaction. These results suggest that LPV/r TAB-QD provides multiple benefits relative to SGC with patients valuing QD, fewer pills, and no food or refrigeration requirements. Additional assessments of TAB-QD’s tolerability profile are warranted. |
| 84 | TOLERABILITY OF LOPINAVIR/RITONAVIR LIQUID IN HIV-POSITIVE ADULTS SWITCHED FROM THE SOFT-GEL CAPSULE (SGC) FORMULATION Antiviral Therapy 2006; 11(Suppl. 3):L52 J Toy1, M Harris2, J da Silva1, B Yip3 and JSG Montaner3 Following a switch from lopinavir/ritonavir capsules to liquid, GI side effects improved in 26% and worsened in 24%, and 66% discontinued. Patients naïve to lopinavir/ritonavir were less likely to remain on the liquid formulation (89% discontinued). Unpleasant taste, inconvenience and GI symptoms limited the use of this alternative dosage form. |
| 85 | EVALUATION OF THE LIPOGENIC BENEFIT OF FOSAMPRENAVIR (FPV) WHEN SUBSTITUTED FOR LOPINAVIR/r (LPV/r) Antiviral Therapy 2006; 11(Suppl. 3):L52 PJ Ruane and B Alas After a switch from LPV/r to FPV (unboosted), viral control persisted and serum total cholesterol, various LDLc/HDLc fractions, glycemia, and plasma insulin remained unchanged. Serum triglycerides and ‘large VLDL’ particles decreased significantly, beginning at week 4, indicating a shift to a lower cardiovascular risk zone. This data may be useful to providers managing patients’ metabolic profile during HAART therapy. |
| 86 | ABSENCE OF BENEFIT ON BODY COMPOSITION WITH ROSIGLITAZONE OR PRAVASTATIN BUT SHORT TERM IMPROVEMENT OF VISCERAL ADIPOSITY WITH GROWTH HORMONE IN PERSONS WITH HIV-ASSOCIATED LIPOATROPHY (HALS) Antiviral Therapy 2006; 11(Suppl. 3):L53 DC Macallan1, S Mandalia2, G Panayiotakopoulos1, V Pandol-Kaljevic1, C Baldwin2 and GJ Moyle2 In HALS, neither pravastatin nor rosiglitazone appear useful therapies for reversal of body composition changes. rhGH is effective at reducing visceral fat but its effects are short-lived. The exacerbation of insulin resistance seen with rhGH can be reduced by co-administration of rosiglitazone. |
| 87 | LIPID AND NON-LIPID LOWERING BENEFITS OF ATORVASTATIN IN PATIENTS ON HAART WITH INCREASED LOW-DENSITY LIPOPROTEIN (LDL) CHOLESTEROL LEVELS Antiviral Therapy 2006; 11(Suppl. 3):L53 AP Liappis, AC Laborico, JE Clarke, NJ Bisby, B Yoon, M Javid, SZ Schuck, AA Desrosiers, AD Roberts, DM Parenti and GL Simon Atorvastatin was effective in the reduction of PAR-associated lipoprotein subclasses and lowered sEselectin, a marker of activated endothelium. While on HAART, inflammatory parameters were also altered. The anti-inflammatory profile could not be attributed to a dose-effect in our analyses. Low dose atorvastatin reduced pro-atherogenic predictors and may confer additional benefits by modulating inflammation in patients with antiretroviral therapy-associated metabolic complications. |
| 88 | REDUCTION OF STAVUDINE DOSE WHILE ON HAART MAINTAINS VIRAL SUPPRESSION Antiviral Therapy 2006; 11(Suppl. 3):L54 P Shalit and M McClarty The current study provides evidence of the efficacy of HAART containing reduced dose stavudine. However, dose-reduction in stable patients did not always prevent later toxicities. Because stavudine remains an important antiretroviral agent, especially in the developing world, prospective studies of reduced-dose stavudine should be undertaken. |
| 89 | THE StARS STUDY OF ONCE DAILY ATAZANAVIR, LOW-DOSE RITONAVIR AND SAQUINAVIR: 48 WEEK EFFICACY AND SAFETY RESULTS Antiviral Therapy 2006; 11(Suppl. 3):L54 AE Colson, CJ Cohen, JA Hellinger, K McLaughlin and A Habel In this pilot study, patients suppressed on LPV/r and SQV (±NRTIs) maintained suppression and demonstrated a downward trend in visceral adiposity 48 weeks after substituting ATV/r for LPV/r and changing twice daily SQV to once daily SQV (1200–1600 mg QD). |
| 90 | TIME UNTIL CHANGE OF FIRST-LINE ANTIRETROVIRAL THERAPY IN PATIENTS RECEIVING NNRTI AND PROTEASE INHIBITOR (PI)-CONTAINING REGIMENS Antiviral Therapy 2006; 11(Suppl. 3):L55 A Gurjanov, S Gerschmann, M Lubach-Ruitmann, M Stoll, RE Schmidt and GMN Behrens Therapy changes for any reason in first line HAART in an unselected patient cohort appear more frequently than expected from literature reports of selected cohorts or clinical trails. NNRTI, particularly NVP-NRTI combinations seem to be more stable after the first year and even beyond the third year of therapy. |
| 91 | A RANDOMIZED, OPEN-LABEL, MULTICENTRE TRIAL COMPARING THE EFFECTS OF FENOFIBRATE AND THE COMBINATION OF FENOFIBRATE WITH L-CARNITINE ON HIV/HAART-RELATED HYPERTRIGLYCERIDEMIA (CTN 157 STUDY) Antiviral Therapy 2006; 11(Suppl. 3):L55 E Toma1, M Loignon1, E Yu2, A Thorne2, F Smaill3, D Zarowny2, M Harris2, A Piché4, B Conway5, J Singer2 and CTN 157 study group All patients experienced significant reductions in triglyceride levels. Unexpectedly, a greater proportion of patients in the fenofibrate arm achieved the primary outcome and showed greater reductions from baseline on all outcomes, although none of the differences between treatment arms were statistically significant. |
| 92 | THE IMPACT OF RECOMBINANT HUMAN GROWTH HORMONE (R-HGH) ON BODY IMAGE AND HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN PATIENTS WITH HIV-ASSOCIATED ADIPOSE REDISTRIBUTION SYNDROME (HARS) Antiviral Therapy 2006; 11(Suppl. 3):L56 RR Turner1, MA Testa2, M Thompson3, E Daar4, N Muurahainen5 and DP Kotler6 Compared to placebo, r-hGH induction therapy significantly improved key indicators of HARS and resulted in significant and clinically important improvements in body image, despite known side effects. Moreover, improvements in body image were, in turn, associated with significantly improved overall HRQOL. |
| 93 | INACCURACY OF SERUM GLUCOSE MEASUREMENT IN CLINICAL PRACTICE Antiviral Therapy 2006; 11(Suppl. 3):L57 TC Pitea, E Engelson, M Sharma and DP Kotler This experiment identified a persistent difference in glucose levels between clinical and criterion methods. While a small difference was anticipated, the observed error was larger than expected. These results draw attention to the current methods of screening for diabetes and emphasize the need for development of a systematic approach to avoid errors in assessing glucose metabolism. Our findings suggest that glucose levels obtained from common chemistry panels are not reliable to screen for glucose intolerance. |
| 94 | INACCURACY OF SERUM INSULIN MEASUREMENT IN CLINICAL PRACTICE Antiviral Therapy 2006; 11(Suppl. 3):L57 TC Pitea, E Engelson, M Sharma and DP Kotler This experiment identified a persistent error in insulin levels between clinical and criterion methods. Since both labs use standardized methods for insulin measurement, the observed difference between the test results could be due to sample handling. Our findings suggest that lack of refrigeration between sample collection and processing leads to serious underestimation of insulin levels. Underestimation of fasting insulin concentrations in clinical laboratories is a major confounder in the detection of hyperinsulinemia and insulin resistance. |
| 95 | ADVERSE EVENTS LEADING TO DRUG DISCONTINUATION IN CTN 164: THE CANADIAN RANDOMIZED TRIAL OF STRUCTURED TREATMENT INTERRUPTION PRIOR TO SALVAGE ANTIRETROVIRAL THERAPY Antiviral Therapy 2006; 11(Suppl. 3):L58 S Walmsley1, N LaPierre2, R Woods2, J Haye2 and A Thorne2, for the CTN 164 Investigators Adverse events leading to drug discontinuation in a salvage regimen were frequent in the CTN 164 trial. Although the number of discontinuations was lower in the STI arm they occurred sooner than in the IS arm. Adherence to the salvage regimen could have significant implications on a primary endpoint of viral load suppression. |
| 96 | GENDER AND RACE SUBGROUP ANALYSES IN FOUR LARGE, RANDOMIZED CLINICAL TRIALS COMPARING ABACAVIR (ABC) TO PROTEASE INHIBITORS (PI) OR ZIDOVUDINE (ZDV) IN ART-NAÏVE SUBJECTS Antiviral Therapy 2006; 11(Suppl. 3):L58 K Tashima1, P Kumar2, A Rodriguez-French3, E DeJesus4, PG Wannamaker5, CH Brothers5, QM Liao5 and JE Hernandez5 Virological and immunologic responses and drug tolerability were broadly similar or better in the ABC-containing group versus the non-ABC containing group. Apparent differences in response among some subgroups deserve further study. |
| 97 | ADHERENCE TO A DIET AND EXERCISE PROGRAM PRODUCES SIGNIFICANT INCREASES IN HDL LEVELS WITHOUT WORSENING OF LIPOATROPHY IN PATIENTS UNDER ANTIRETROVIRAL TREATMENT (LUNES STUDY) Antiviral Therapy 2006; 11(Suppl. 3):L59 WH Belloso1, MdL Sanchez1, RH Rey2, IM Otegui1, LO Clara1, LA Barcan1, S Gutt3, A Delfante3, AM Galich4 and GD Lopardo5 This study indicates that a non-pharmacological intervention can significantly improve the HDL-cholesterol profile in adherent patients without a negative impact on peripheral lipoatrophy. Nevertheless, maintenance of lifestyle modifications constitutes a difficult goal even in the context of a randomized study. |
| 98 | FACTORS INVOLVED IN THE LIPOHYPERTROPHY IN FACIAL FAT GRAFTING FOR THE TREATMENT OF THE LIPOATROPHY Antiviral Therapy 2006; 11(Suppl. 3):L59 J Fontdevila1, E Martínez2, J Rubio-Murillo1, JM Serra-Renom1 and J Gatell2 Lipohypertrophy is a condition that may occur after facial filling with autologous fat tissue. Weight increase and increased volumes of fat graft used were the most important factors involved. Limiting the volume of fat grafted was the most important measure taken to avoid it without compromising the aesthetic results. |
| 99 | LONG-TERM SAFETY AND EFFICACY OF EUTROPHILL FOR TREATMENT OF HIV-ASSOCIATED FACIAL LIPOATROPHY Antiviral Therapy 2006; 11(Suppl. 3):L60 E Carbonnel1, B Mole2, M Kazatchkine2 and A Claudy1 A satisfactory cosmetic result was obtained in all our patients. Our study showed that Eutrophill is an easy-to-use product without significant side effects after a 5-year follow-up. |
| 100 | COMPLICATIONS WITH BIOALCAMID® IN THE AESTHETIC TREATMENT OF LIPOATROPHY Antiviral Therapy 2006; 11(Suppl. 3):L60 J Fontdevila1, E Martínez2, E Guisantes1, JM Serra-Renom1 and J Gatell2 The implant shows a good tolerability when is recently implanted but over the time the complications appear and these are difficult to manage so it requires of invasive procedures that lead to explantation of the material with economic and psychological consequences for the patients. |
| 101 | LONG-TERM EVOLUTION OF LIPOSUCTIONED AREAS IN FAT ACCUMULATION IN LIPODYSTROPHY Antiviral Therapy 2006; 11(Suppl. 3):L61 J Fontdevila1, E Martínez2, M Raigosa1, JM Serra-Renom1 and J Gatell2 The abdominal area and the lateral back use to be disappointing areas and a meticulous evaluation have to be done before indicating any surgical treatment. Dietetic intervention can play a role in preventing fat accumulation and its recurrence. |
| 102 | LONG LASTING PSYCHO-SOCIAL BENEFITS OF POLYACRYLAMIDE INJECTIONS FOR THE TREATMENT OF FACIAL LIPOATROPHY Antiviral Therapy 2006; 11(Suppl. 3):L61 G Orlando1, G Guaraldi1, N Squillace1, M Vandelli2, M De Paola2, L Cardinali2, D Comelli2,G De Santis1, A Pedone1, A Spaggiari1, A Baccarani1, M Pinelli1, G Nardini1, B Beghetto1 and R Esposito1 Polyacrylamide injections resulted in long lasting psycho-social benefits. We suggest that simple and reproducible psychometric evaluations should be used in clinical practice and should be taken as outcomes for surgical interventions for HIV related lipoatrophy. |
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| 103 | HIV-1 PROTEASE INHIBITORS SELECTIVELY INDUCE GENE EXPRESSION ALTERATIONS ASSOCIATED WITH REDUCED CALCIUM DEPOSITION IN PRIMARY HUMAN OSTEOBLASTS Antiviral Therapy 2006; 11(Suppl. 3):L62 AP Malizia, EC Cotter, WG Powderly and PP Doran Our data suggests a link between reduced osteoblastic phenotype and a group of 21 altered genes following NFV and IDV treatment, and also suggests TIMP-3 may involved in the PI induced inhibition of osteoblast function. |
| 104 | HIV PROTEINS SUPPRESS OSTEOBLAST FUNCTION VIA MODULATION OF RUNX-2 AND PPARγ TRANSCRIPTION FACTOR ACTIVITY Antiviral Therapy 2006; 11(Suppl. 3):L62 EJ Cotter, N Chew, WG Powderly and PP Doran Our findings suggest that exposure to HIV proteins decreases bone formation in osteoblasts and this change in phenotype is paralleled by alterations in RUNX-2 and PPARγ transcription factor activity in osteoblasts. Alterations of these activities may provide a molecular mechanism that contributes to HIV-associated reduction in BMD. |
| 105 | PLASMA RANKL, OPG, TRAIL AND DECREASE OF BONE MINERAL DENSITY IN HIV-1 ANTIRETROVIRAL-NAÏVE INFECTED PATIENTS Antiviral Therapy 2006; 11(Suppl. 3):L63 M Borderi1, D Gibellini2, F Vescini3, MC Re2, R Caudarella3 and F Chiodo1 These data indicate that RANKL may act on HIV-1 related BMD decrease especially in the presence of low OPG/RANKL ratio suggesting an interesting mechanism for osteoporosis/osteopenia displayed in the course of HIV-1 infection. |
| 106 | THE EFFECT OF THE HIV PROTEASE INHIBITORS INDINAVIR AND LOPINAVIR/RITONAVIR ON THROMBOLYTIC FACTORS Antiviral Therapy 2006; 11(Suppl. 3):L63 GA Lee PIs do not directly contribute to increased tPA antigen levels observed in HIV-infected patients. PAI-1 levels did not change in the indinavir, lopinavir/ritonavir, or combined groups. PIs do not directly contribute to the increased PAI-1 levels observed in HIV-infected patients. |
| 107 | PREVALENCE OF DRY SKIN AND ASSOCIATED FACTORS IN THE STUDY OF FAT REDISTRIBUTION AND METABOLIC CHANGE IN HIV INFECTION (FRAM) Antiviral Therapy 2006; 11(Suppl. 3):L64 C Benson, D Lee, CE Lewis, R Scherzer and C Grunfeld Dry skin is more common in HIV+ versus controls. In HIV+ subjects, dry skin is associated with low CD4 count and in men with indinavir use. |
| 108 | CHARACTERIZATION OF NEUTROPENIA IN HIV-INFECTED (HIV+) SUBJECTS TREATED WITH ANTIRETROVIRAL THERAPY (ART) WITH AND WITHOUT ZIDOVUDINE (ZDV) IN 34 CLINICAL TRIALS Antiviral Therapy 2006; 11(Suppl. 3):L64 MT Edwards, WS Burkle, AG Cutrell, QM Liao, CH Brothers and JE Hernandez The overall incidence of severe neutropenia in this cohort was low (3.1%). Subjects receiving ZDV had a higher incidence of neutropenia compared to subjects not receiving ZDV, but this incidence was also low. Baseline neutrophil counts, CD4+ cell counts and other characteristics were identified as potential ZDV-independent determinants of neutropenia. |
| 109 | INCIDENCE OF ANEMIA AMONG PATIENTS TREATED WITH ZIDOVUDINE Antiviral Therapy 2006; 11(Suppl. 3):L65 SM Curkendall, J Richardson and MF Emons Upon adjusting for other factors, ZDV use was associated with increased anaemia risk in patients without baseline anaemia and of worsening anaemia in those with baseline anaemia. Nearly 1/5 of new anaemia cases among patients treated with ZDV required epo or blood transfusions. |
| 110 | INCIDENCE OF ADVERSE REACTIONS AND REASONS OF TREATMENT DISCONTINUATION IN PATIENTS TREATED WITH LOPINAVIR/r IN THE SCOLTA PROJECT COHORT Antiviral Therapy 2006; 11(Suppl. 3):L65 P Bonfanti1, E Ricci1, S Rusconi1, C Martinelli2, S Carradori3, C Magnani4, G Cristina5, G De Socio6, G Parruti7, G Orofino8, D Migliorini9 and T Quirino10 The rate of adverse events per 100 person-years was 9.7 (95% CI 9.5–9.9); 6.3 (95% CI 6.0–6.6) in naïve patients and 10.4 (95% CI 10.2–10.6) in experienced. Women had an incidence rate lower than men (8.9, 95% CI 8.6–9.2 and 10.0, 95% CI 9.8–10.2 respectively). |
| 111 | OVERALL SAFETY PROFILE OF TDF+ddI CONTAINING REGIMENS IN PATIENTS WHO DECIDED TO CONTINUE ON THIS COMBINATION OR SELECTIVELY CHANGED ONE OF THE NUCLEOSIDES: RESULTS FROM THE DIDITEN COHORT Antiviral Therapy 2006; 11(Suppl. 3):L66 V Boix1, P Domingo2, D Podzamczer3, JL Casado4, M Cervero5, A Ocampo6, E Condes7, S Perez8, S Moreno4 and the DIDITEN study group The overall safety profile in this cohort was good, with 8.6% of AE related to TDF (2.5%) or ddI (6.1%). Only 1.9% of patients changed selectively TDF or ddI due to toxicity. |
| 112 | INJECTION SITE REACTIONS (ISRS) AND QUALITY OF LIFE (QoL) DURING ENFUVIRTIDE (ENF) TREATMENT: QUALITE STUDY FINAL RESULTS Antiviral Therapy 2006; 11(Suppl. 3):L66 P Shalit, A True and J Thommes Significant improvements in QoL, CD4 counts, and HIV RNA are consistent with previous studies. However, significant predictors of QoL benefits were not identified. Limitations of this trial include lack of a comparison patient group and duration of follow-up. Use of the thin-walled, 31-gauge/8 mm needles was generally well tolerated and represents a viable ENF administration option. |
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