title: Improvement in lipoatrophy associated with highly active antiretroviral therapy in human immunodeficiency virus-infected patients switched from stavudine to abacavir or zidovudine: the results of the TARHEEL study.
abstract: Stavudine use is a contributing factor for lipoatrophy, whereas use of abacavir or zidovudine is less likely to cause this complication. The TARHEEL study was a 48-week, open-label study that assessed changes in lipoatrophy after abacavir (86 patients [73%]) or zidovudine (32 patients [27%]), 300 mg twice daily, was substituted for stavudine for 118 human immunodeficiency virus (HIV)-infected patients (HIV type 1 RNA level, <400 copies/mL) with virological suppression who had developed lipoatrophy after > or =6 months of stavudine-based treatment. At week 48, full-body dual-energy x-ray absorptiometry demonstrated a median increase in arm fat of 35%, leg fat of 12%, and trunk fat of 18%, compared with the baseline level. These improvements coincided with fat gain in lipoatrophic areas that was documented by computerized tomography. Results of a "body image" questionnaire showed that a substantial percentage of patients reported some or a lot of fat gain in the arms (22%), legs (18%), buttocks (19%), and face (27%). HIV suppression was maintained over the study period. In conclusion, replacing stavudine with abacavir or zidovudine resulted in improvement in stavudine-induced lipoatrophy.
authors.affiliation: Case Western Reserve, Cleveland, Ohio, USA. mccomsey.grace@clevelandactu.org
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Ward
authors.forename: Siegrid M
authors.initials: SM
authors.lastname: Hessenthaler
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sension
authors.forename: Peter
authors.initials: P
authors.lastname: Shalit
authors.forename: J Tyler
authors.initials: JT
authors.lastname: Lonergan
authors.forename: Robin L
authors.initials: RL
authors.lastname: Fisher
authors.forename: Vanessa C
authors.initials: VC
authors.lastname: Williams
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Hernandez
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000502:physiology; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral; D018119:Stavudine / Q000009:adverse effects*; D016896:Treatment Outcome; D019562:Viral Load; D015215:Zidovudine / Q000009:adverse effects / Q000627:therapeutic use; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D012367:RNA, Viral; D018119:Stavudine; D015215:Zidovudine; D000099227:Abacavir