Back to Search Start Over

Zidovudine/lamivudine for HIV-1 infection contributes to limb fat loss.

Authors :
Marit G A van Vonderen
Michiel A van Agtmael
Elly A M Hassink
Ana Milinkovic
Kees Brinkman
Suzanne E Geerlings
Matti Ristola
Arne van Eeden
Sven A Danner
Peter Reiss
MEDICLAS study group
Source :
PLoS ONE, Vol 4, Iss 5, p e5647 (2009)
Publication Year :
2009
Publisher :
Public Library of Science (PLoS), 2009.

Abstract

Lipoatrophy is known to be associated with stavudine as part of the treatment for HIV infection, but it is less clear if this serious side effect is also related to other nucleoside reverse transcriptase inhibitors like zidovudine. We aimed to determine whether zidovudine-sparing first-line antiretroviral therapy would lead to less lipoatrophy and other metabolic changes than zidovudine-containing therapy.Fifty antiretroviral therapy-naïve HIV-1 infected men with an indication to start antiretroviral therapy were included in a randomized single blinded clinical trial. Randomisation was between zidovudine-containing therapy (zidovudine/lamivudine+lopinavir/ritonavir) and zidovudine-sparing therapy (nevirapine+lopinavir/ritonavir). Main outcome measures were body composition assessed by computed tomography and dual-energy X-ray absorptiometry scan and lipid profile before and after 3, 12, 24 months of antiretroviral therapy. In the zidovudine/lamivudine+lopinavir/ritonavir group, from 3 months onward limb fat decreased progressively by 684+/-293 grams (estimated mean+/-standard error of the mean)(p = 0.02) up to 24 months whereas abdominal fat increased, but exclusively in the visceral compartment (+21.9+/-8.1 cm(2), p = 0.008)). In contrast, in the nevirapine+lopinavir/ritonavir group, a generalized increase in fat mass was observed. After 24 months no significant differences in high density lipoprotein and total/high density lipoprotein cholesterol ratio were found between both treatment groups, but total and low density lipoprotein cholesterol levels were higher in the nevirapine+lopinavir/ritonavir group (6.1+/-0.2 versus 5.3+/-0.2 and 3.6+/-0.1 versus 2.8+/-0.1 mmol/l respectively, p

Subjects

Subjects :
Medicine
Science

Details

Language :
English
ISSN :
19326203
Volume :
4
Issue :
5
Database :
Directory of Open Access Journals
Journal :
PLoS ONE
Publication Type :
Academic Journal
Accession number :
edsdoj.09bf51340a134ed5b30f035850d7d837
Document Type :
article
Full Text :
https://doi.org/10.1371/journal.pone.0005647