Abstract:
INTRODUCTION:Lipodystrophy is still a matter of concern in HIV+ patients receiving ART. However, long-term fat change in patients taking non-thymidine regimens is not well known. MATERIALS AND METHODS:A prospective ongoing fat change assessment including clinical evaluation and dexa scans (Hologic QDR 4500) is being conducted in all consecutive patients initiating ART from January 2008. Arm, leg, trunk and total fat as well as fat mass ratio (FMR=% trunk fat/% leg fat) were determined. Patients with data at baseline (BL), 12 and 36 m are included in this analysis. ITT and OT were performed. Multivariate general linear models were used to assess changes in fat measures. RESULTS:One hundred patients were included. 81% men, 42.9 years, 18% AIDS, CD4 218.5 (6-756), viral load 5 log (2.9-6.8), leg fat 4644g, trunk fat 6693g, FMR 0.94. Around 40 patients (40%) initiated a PIr (17 LPVr, 11 ATVr, 9 DRVr, 3 FPVr), 34 (34%) NVP and 21 (21%) EFV. About 83% received TDF/FTC and 10% ABC/3TC. Groups were comparable at BL except for a lower viral load in NVP patients (p=0.047) and lower c-LDL in PI patients (p=0.043). After 36 m, no patient presented a clinically evident lipodystrophy. At 12 m, an overall significant increase was found from baseline in trunk, leg and FMR (median 759 g, 479.4 g and 0.03, respectively, p<0.05) and at 36 m in trunk and leg fat (median 989.9 g, 566 g, respectively, p<0.05). According to ART, at 12 m a significant increase in trunk and leg fat was observed in EFV and PIr. At 36 m, in NVP patients trunk and leg fat as well as FMR increased, whereas in PIr patients only leg fat increased (see figure). In ITT analysis, adjusted by age, sex, risk practice and BL CD4, EFV was associated with a greater increase in FMR (p=0.036) at 36 m vs PIr. In OT analysis, at 12 m, NVP was associated with a smaller percentage increase in trunk fat (vs PIr and EFV, p=0.006) and in leg fat (vs PIr, p=0.046). These differences did not persist at 36 m. CONCLUSIONS:In this cohort of patients taking non-thymidine-based regimens, after 36 m without a clinically evident lipodystrophy, no significant changes in FMR were observed. However, some differences in fat redistribution according to ART were present: PIr was associated with an initial and continuous increase in trunk and leg fat, NVP with a slower and progressive increase in both fat compartments, while in EFV patients, the initial fat increase was followed by a decrease in peripheral fat at 36 m. Longer follow up will help to confirm these trends.
journal_name
J Int AIDS Socjournal_title
Journal of the International AIDS Societyauthors
Ferrer E,Navarro A,Curto J,Medina P,Rozas N,Barrera G,Saumoy M,Tiraboschi JM,Gomez C,Podzamczer Ddoi
10.7448/IAS.17.4.19553subject
Has Abstractpub_date
2014-11-02 00:00:00pages
19553issue
4 Suppl 3issn
1758-2652pii
19553journal_volume
17pub_type
杂志文章abstract:INTRODUCTION:The 48-week interim analysis of the MODAT study showed that confirmed virologic failure (CVF) was more frequent in patients simplifying to ATV/r monotherapy compared to maintaining ATV/r-based triple therapy. The DSMB recommended stopping study enrollment but continuing follow-up of enrolled patients. We p...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19806
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abstract:INTRODUCTION:Scientific research has demonstrated the clinical benefits of earlier initiation of antiretroviral treatment (ART), and that ART can markedly reduce HIV transmission to sexual partners. Ensuring universal access to ART for those who need it has long been a core principle of the HIV response, and extending ...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.1.19320
更新日期:2014-07-18 00:00:00
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doi:10.7448/IAS.20.4.21475
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abstract:INTRODUCTION:Optimal adherence to antiretroviral therapy is closely related with suppression of the HIV viral load in plasma, slowing disease progression and decreasing HIV transmission rates. Despite its importance, the estimated proportion of people living with HIV in Latin America and the Caribbean with optimal adhe...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,meta分析
doi:10.1002/jia2.25066
更新日期:2018-01-01 00:00:00
abstract:INTRODUCTION:We report the SVR12 final analysis of a phase 3 study of telaprevir in combination with peginterferon (P)/ribavirin (R) in HCV-genotype 1, treatment-naïve and -experienced patients with HCV/HIV co-infection (INSIGHT). MATERIALS AND METHODS:Patients receiving stable, suppressive HIV antiretroviral (ARV) th...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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journal_title:Journal of the International AIDS Society
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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journal_title:Journal of the International AIDS Society
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
doi:10.7448/IAS.19.1.20913
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.15.2.17422
更新日期:2012-11-21 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25059
更新日期:2018-01-01 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,评审
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更新日期:2017-11-01 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,meta分析,评审
doi:10.7448/IAS.19.1.20992
更新日期:2016-11-02 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.4.19946
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19724
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:HIV diagnoses among gay and bisexual men have increased over the past decade in Australia. HIV point-of-care testing (POCT) was introduced in Australia in 2011 as a strategy to increase HIV testing by making the testing process more convenient. We surveyed gay and bisexual men undergoing POCT to assess bar...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.18.1.20221
更新日期:2015-08-27 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19680
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:Antiretroviral (ARV)-based pre-exposure prophylaxis (PrEP) is a promising new HIV prevention strategy. However, variable levels of adherence have yielded mixed results across several PrEP trials and populations. It is not clear how taking ARV - traditionally used for HIV treatment - is perceived and how th...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
doi:10.7448/IAS.17.3.19146
更新日期:2014-09-08 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19745
更新日期:2014-11-02 00:00:00
abstract:INTRODUCTION:The Robert Koch Institute (RKI) aimed to assess a molecular surveillance strategy based on filter-dried serum spots (DSS) of all newly diagnosed HIV infections in Germany. In 2013, diagnostic laboratories sent DSS to the RKI representing 55% of the newly diagnosed HIV infections reported to the RKI (protec...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.7448/IAS.17.4.19670
更新日期:2014-11-02 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25325
更新日期:2019-07-01 00:00:00
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journal_title:Journal of the International AIDS Society
pub_type: 杂志文章
doi:10.1002/jia2.25577
更新日期:2020-08-01 00:00:00
abstract:INTRODUCTION:Global guidelines emphasize the ethical obligation of investigators to help participants in HIV-endpoint trials reduce HIV risk by offering an optimal HIV prevention package. Oral pre-exposure prophylaxis (PrEP) has increasingly become part of state-of-the-art HIV prevention. Here we describe the process o...
journal_title:Journal of the International AIDS Society
pub_type: 杂志文章,随机对照试验
doi:10.1002/jia2.25491
更新日期:2020-05-01 00:00:00