AEGiS-13IAC: Differential effects of zidovudine and stavudine on fat distribution and its associated the metabolic abnormalities in HIV-infected patients on highly active antiretroviral therapy.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Differential effects of zidovudine and stavudine on fat distribution and its associated the metabolic abnormalities in HIV-infected patients on highly active antiretroviral therapy.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrB705)

Domingo P, Francia E, Torres OH, Montiel JA, Perez A, Ordonez J, Rodriguez J, Sambeat MA, Vazquez G
P. Domingo, Hospital de la Santa Creu i Sant Pau, Av. Sant Antoni M. Claret, 167, 08025 Barcelona, Spain, Tel.: +34 93 291 93 43, Fax: +34 93 291 92 69, E-mail: pere.domingo@cc.uab.es

OBJECTIVE: To compare body composition, serum lipid profile lipid, insulin secretion, and endocrine measurements in HIV-1-infected patients whose antiretroviral regime differed only in a nucleoside reverse transcriptase inhibitor (NRTI). Patients and

METHODS: Ninety-eight HIV-infected patients on long-term highly active antiretroviral therapy including stavudine (n = 95) or zidovudine (n = 23). Fat wasting was assessed by physical examination. Regional fat distribution was estimated using caliper measurements of skinfold thickness at four sites. Central adiposity was assessed by measurement of waist-hip ratio.

RESULTS: Both groups were well balanced with respect to age, sex duration of HIV infection, risks factors for acquiring HIV infection, prior AIDS defining conditions, duration of HAART, daily caloric intake, CD4 cell counts, HIV-1 RNA and percent of undetectacble plasma viral load. The proportion of antiretroviral naive patients was significantly greater in the stavudine-treated group (26.7% vs. 0%, p = 0.01) but the mean time of exposure to NRTIs prior to HAART was not significantly different (46.9 é 30.7 vs. 45.0 é 32.1 months, p = .81). The lean body mass and fat parameters of body composition were similar among the groups either when expressed in absolute numbers ore when expressed as percentage of body weight. There were no statistically significant differences between the skinfold thickness measured at four different sites, nor there were between arm and leg or metabolic parameters. However, all these measures tended to be reduced in the stavudine-treated group. Visceral adiposity estimated through the waist-hip ratio was not statistically different in both groups.

CONCLUSION: There were not differences with respect to anthropometric or metabolic parameters between patients heavily pre-treated with NRTIs who received a stavudine-based or a zidovudine-based HAART.

Keywords: AEGIS, Stavudine, Zidovudine, Antiretroviral Therapy, Highly Active, HIV Infections, Reverse Transcriptase Inhibitors, HIV-1, CD4 Lymphocyte Count, Body Composition, Viral Load, Fats, HIV Seropositivity, Obesity, Acquired Immunodeficiency Syndrome, Human
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