title: Changes in body fat composition after 1 year of salvage therapy with lopinavir/ritonavir-containing regimens and its relationship with lopinavir plasma concentrations.
abstract: OBJECTIVE
  To determine whether an association existed between lopinavir (LPV) plasma concentrations and changes in body fat composition.
  
  
  METHODS
  A prospective, non-randomized study.
  
  
  METHODS
  HIV clinic of a University Hospital.
  
  
  METHODS
  HIV-infected subjects who had virological failure on protease inhibitor-containing regimens. Twenty-two consecutive patients were enrolled, 19 completed 24 weeks of treatment and 16 completed the full 48-week study period.
  
  
  METHODS
  Patients were treated with LPV/ritonavir (LPV/r) in combination with other antiretroviral agents. LPV trough plasma concentrations were measured at baseline and weeks 4, 8, 12, 24, 36 and 48. Body fat composition was quantified by computerized tomographic scanning at baseline, and weeks 24 and 48.
  
  
  RESULTS
  LPV trough concentrations correlated with absolute and proportional changes in limb fat from baseline to week 48. Significant differences were found in mean LPV trough concentrations between patients losing less than 5% of limb fat, those experiencing a limb fat loss between 5 and 20%, and those losing more than 20% at week 24 [mean (SD), 4.67 (1.67); 8.57 (1.77); 9.49 (2.67) microg/ml, respectively; P=0.013] and week 48 [mean (SD), 4.5 (2.24); 7.04 (1.77); 9.7 (2.8) microg/ml, respectively; P=0.027]. Most patients losing more than 5% of limb fat during LPV/r therapy had mean LPV trough concentrations > or = 8 microg/ml.
  
  
  CONCLUSIONS
  In patients receiving salvage therapy with LPV/r there was an association between LPV plasma trough concentrations and limb fat loss. The risk of peripheral limb fat loss may be greater among patients achieving higher LPV trough concentrations.
authors.affiliation: Infectious Diseases Unit, Internal Medicine Department, Hospital General Universitario de Elche, Alicante, Spain. gutierrez_fel@gva.es
authors.forename: Félix
authors.initials: F
authors.lastname: Gutiérrez
authors.forename: Sergio
authors.initials: S
authors.lastname: Padilla
authors.forename: Mar
authors.initials: M
authors.lastname: Masiá
authors.forename: Andrés
authors.initials: A
authors.lastname: Navarro
authors.forename: Juan
authors.initials: J
authors.lastname: Gallego
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Hernández
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Ramos
authors.forename: Alberto
authors.initials: A
authors.lastname: Martin-Hidalgo
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000187:drug effects; D019380:Anti-HIV Agents / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019540:Area Under Curve; D001823:Body Composition / Q000187:drug effects*; D015992:Body Mass Index; D001835:Body Weight; D018791:CD4 Lymphocyte Count; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D061466:Lopinavir; D011446:Prospective Studies; D011744:Pyrimidinones / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019438:Ritonavir / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016879:Salvage Therapy / Q000379:methods; D014057:Tomography, X-Ray Computed
chemical_list: D019380:Anti-HIV Agents; D011744:Pyrimidinones; D061466:Lopinavir; D019438:Ritonavir