Role of long-term nucleoside-analogue therapy in lipodystrophy and metabolic disorders in human immunodeficiency virus-infected patients.
The role of nucleoside analogues (NAs) in lipodystrophy (LD) syndrome in human immunodeficiency virus (HIV)-infected patients remains controversial. We studied the prevalence of LD in previously untreated patients randomized to receive different NA combinations (in the ALBI-ANRS 070 trial) for 6 months. At month 30 of follow-up, 37 (31%) of 120 patients had >/=1 morphologic change, and 21 (57%) of 37 had isolated peripheral lipoatrophy; corresponding values for the patients who received only NAs throughout follow-up were 20 (30%) of 66 and 14 (67%) of 21, respectively. In multivariate analysis, factors associated with presence of LD at month 30 were initial assignment to the group receiving stavudine and didanosine (odds ratio [OR], 6.7; P=.02), age (OR for being 10 years older, 3.6; P=.002), and HIV RNA level at month 30 (OR, 0.4; P=.007). No difference was observed in cholesterol and glucose levels as a function of any pattern of antiretroviral exposure. Exposure to stavudine and didanosine was associated with LD syndrome (predominantly lipoatrophy).
Chêne
Geneviève
G
INSERM Unité 330, Université Victor Segalen Bordeaux 2, 33076 Bordeaux Cédex, France. genevieve.chene@isped.u-bordeaux2.fr
Angelini
Emmanuelle
E
Cotte
Laurent
L
Lang
Jean-Marie
JM
Morlat
Philippe
P
Rancinan
Corinne
C
May
Thierry
T
Journot
Valérie
V
Raffi
François
F
Jarrousse
Bernard
B
Grappin
Michèle
M
Lepeu
Gérard
G
Molina
Jean-Michel
JM
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced* / Q000209:etiology; D008297:Male; D008659:Metabolic Diseases / Q000139:chemically induced* / Q000209:etiology; D015999:Multivariate Analysis; D009705:Nucleosides / Q000009:adverse effects* / Q000627:therapeutic use
D019380:Anti-HIV Agents; D009705:Nucleosides