Switching to lopinavir/ritonavir with or without abacavir/lamivudine in lipoatrophic patients treated with zidovudine/abacavir/lamivudine
| Autor: | J I, Bernardino, F, Pulido, E, Martinez, J, Arrizabalaga, P, Domingo, J, Portilla, A, Ocampo, J, Muñoz, R, Torres, J R, Arribas, Livia, Giner |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Lipodystrophy Chemistry Pharmaceutical Lopinavir/ritonavir HIV Infections Gastroenterology Lopinavir Absorptiometry Photon immune system diseases Abacavir Antiretroviral Therapy Highly Active NRTI-sparing regimen Pharmacology (medical) Treatment Failure Lipoatrophy lipoatrophy ritonavir monotherapy virus diseases Lamivudine Middle Aged Lipids Intention to Treat Analysis Infectious Diseases Adipose Tissue Body Composition Reverse Transcriptase Inhibitors Female medicine.drug Adult Microbiology (medical) medicine.medical_specialty Zidovudine Internal medicine medicine Humans Pharmacology Ritonavir business.industry HIV thymidine nucleoside analogues HIV Protease Inhibitors Abacavir/Lamivudine medicine.disease Dideoxynucleosides lopinavir Atrophy business |
| Zdroj: | JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 0305-7453 |
| Popis: | BACKGROUND Discontinuation of thymidine nucleoside reverse transcriptase inhibitors (tNRTIs) is the only proven strategy for improving lipoatrophy. It is unclear whether switching to NRTI-sparing or to non-thymidine NRTI-containing therapy has differential effects on body fat recovery. METHODS This was a 96 week, open-label, randomized study in suppressed patients with moderate/severe lipoatrophy and no prior virological failure while receiving a protease inhibitor and who had their triple NRTI regimen (zidovudine/lamivudine/abacavir) switched to lopinavir/ritonavir plus abacavir/lamivudine for a 1 month run-in period and then randomized to lopinavir/ritonavir plus abacavir/lamivudine versus lopinavir/ritonavir monotherapy. The KRETA trial is registered with ClinicalTrials.gov (number NCT00865007). RESULTS Of 95 patients included, 88 were randomized to lopinavir/ritonavir plus abacavir/lamivudine (n = 44) or lopinavir/ritonavir monotherapy (n = 44). Median (IQR) baseline limb fat was 2.5 (1.6-3.7) kg in the lopinavir/ritonavir plus abacavir/lamivudine group and 2.5 (2.0-5.4) kg in the lopinavir/ritonavir monotherapy group. Six patients in the triple therapy group and 13 in the monotherapy group had discontinued study drugs by week 96. Although there were limb fat gains in each group at weeks 48/96 (+324/+358 g in lopinavir/ritonavir plus abacavir/lamivudine, P = 0.09/0.07, versus +215/+416 g in the lopinavir/ritonavir monotherapy group, P = 0.28/0.16), differences between groups were not significant [difference +109 g (95% CI -442, +660)/-57 g (95% CI -740, +625)]. CONCLUSIONS In lipoatrophic patients treated with zidovudine/lamivudine/abacavir, switching to lopinavir/ritonavir monotherapy had no additional benefit in limb fat recovery relative to switching to lopinavir/ritonavir with abacavir/lamivudine. These data suggest that non-thymidine nucleosides such as abacavir/lamivudine are not an obstacle to limb fat recovery. |
| Databáze: | OpenAIRE |
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