The role of nucleoside reverse transcriptase inhibitors in the fat redistribution syndrome.
Fat redistribution associated with the use of antiretroviral therapy, which has been broadly termed 'lipodystrophy', incorporates distinct body composition changes including lipoatrophy (subcutaneous fat loss) as well as fat accumulation. This review examines the role of nucleoside reverse transcriptase inhibitor (NRTI) therapy in the overall context of lipodystrophy, providing converging evidence from observational cohort studies, clinical trials and pathological studies that lipoatrophy is strongly and specifically associated with the use of certain NRTI drugs (stavudine more than zidovudine), and that host factors also have a modulating effect on risk of NRTI-associated lipoatrophy. Implications for clinical assessment and management are also considered, within a broader contest that incorporates treatment efficacy as well as toxicity.
Nolan
David
D
Centre for Clinical Immunology and Biomedical Statistics, 2nd Floor, North Block, Royal Perth Hospital, Wellington Street, Perth, 6000, Western Australia.
Mallal
Simon
S
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects* / Q000379:methods; D020022:Genetic Predisposition to Disease; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced* / Q000473:pathology / Q000821:virology; D006801:Humans; D009705:Nucleosides / Q000009:adverse effects* / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
D009705:Nucleosides; D018894:Reverse Transcriptase Inhibitors