Normalization of fat accrual in lipoatrophic, HIV-infected children switched from stavudine to tenofovir and from protease inhibitor to efavirenz.
Antivir Ther
; 12(3): 297-302, 2007.
Article
de En
| MEDLINE
| ID: mdl-17591019
ABSTRACT
OBJECTIVE:
An antiretroviral regimen based on lamivudine+stavudine+protease inhibitor impairs peripheral fat accrual in HIV-infected children and adolescents. We assess the effect on body composition parameters of replacing stavudine with tenofovir and protease inhibitor with efavirenz in paediatric patients.METHODS:
A 96-week prospective study on 24 patients, (age range 5.0-17.9 years) with stable undetectable HIV-1 loads, who were switched from stavudine to tenofovir and from protease inhibitor to efavirenz. Patient assessment included body composition parameters measured by dual-energy X-ray absorptiometry (DXA), viral load and CD4+ T-count and percentage. As a control group for DXA data, we studied 143 healthy controls (HCs; age range 4.9-20.0 years).RESULTS:
Virological suppression and unchanged CD4+ T-cell count and percentage were maintained in all patients. At baseline, patients showed decreased total, arm and leg fat masses (P < 0.01) but a similar trunk fat mass to HCs. From baseline to week 96, patient fat mass increases were comparable to those for HCs (total fat 1.3 vs 1.2 kg; fat in arms 0.09 vs 0.08 kg; fat in legs 0.5 vs 0.5 kg; trunk fat 0.6 vs 0.6 kg). However, at week 96, total and leg fat mass in patients were still significantly lower than those in HCs (P < 0.02). At baseline and at week 96, lean mass in patients was similar to that expected in HCs.CONCLUSIONS:
Replacing stavudine with tenofovir and protease inhibitor with efavirenz for 96 weeks in lipoatrophic paediatrics patients led to a restoration of physiological fat accrual. Lipoatrophy did not progress but was still present, indicating the need for additional strategies.
Recherche sur Google
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Inhibiteurs de protéases
/
Adénine
/
VIH-1 (Virus de l'Immunodéficience Humaine de type 1)
/
Inhibiteurs de protéase du VIH
/
Stavudine
/
Agents antiVIH
/
Lipodystrophie associée au VIH
/
Benzoxazines
/
Phosphonates
Type d'étude:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limites:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
Antivir Ther
Sujet du journal:
TERAPIA POR MEDICAMENTOS
/
VIROLOGIA
Année:
2007
Type de document:
Article
Pays d'affiliation:
Italie