title: Body composition and metabolic changes in antiretroviral-naive patients randomized to didanosine and stavudine vs. abacavir and lamivudine.
abstract: Comparisons of body composition and metabolic changes among antiretroviral-naive patients randomly assigned to didanosine and stavudine- (ddI+d4T) vs. abacavir and lamivudine- (ABC+3TC) containing regimens were assessed in a nested substudy of an ongoing multicenter randomized trial. At baseline and every 4 months, body cell mass and total body fat were calculated, anthropometric measurements were performed, and fasting metabolic parameters were obtained. The rates of change (unit/mo) estimated using the slopes of regression lines and overall mean changes from baseline were compared by study assignment. Among 96 patients enrolled, 46 received ddI+d4T- and 50 received ABC+3TC-containing regimens with a median follow-up of 32.4 months. For both study arms, an overall increase in the rates of change was seen for body cell mass. For ddI+d4T, after an initial increase, the rates of change declined for regional fat and total body fat compared with an increase for ABC+3TC, with the 2 arms being significantly different (P<0.05). For high-density lipoprotein cholesterol rates of change, ddI+d4T decreased, while ABC+3TC increased. For both arms, low-density lipoprotein cholesterol decreased, while triglycerides increased. Early and sustained increases in insulin and insulin resistance were seen only for ddI+d4T. In this prospective study, metabolic and body composition changes varied according to whether subjects received ddI+d4T or ABC+3TC.
authors.affiliation: Denver Community Programs for Clinical Research on AIDS, Denver Public Health, University of Colorado Health Sciences Center, Denver, CO, USA.
authors.forename: Judith C
authors.initials: JC
authors.lastname: Shlay
authors.forename: Fehmida
authors.initials: F
authors.lastname: Visnegarwala
authors.forename: Glenn
authors.initials: G
authors.lastname: Bartsch
authors.forename: Jack
authors.initials: J
authors.lastname: Wang
authors.forename: Grace
authors.initials: G
authors.lastname: Peng
authors.forename: Wafaa M
authors.initials: WM
authors.lastname: El-Sadr
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gibert
authors.forename: Donald
authors.initials: D
authors.lastname: Kotler
authors.forename: Carl
authors.initials: C
authors.lastname: Grunfeld
authors.forename: Subhasree
authors.initials: S
authors.lastname: Raghavan
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001823:Body Composition / Q000187:drug effects; D016049:Didanosine / Q000009:adverse effects / Q000627:therapeutic use; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D039682:HIV-Associated Lipodystrophy Syndrome / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018119:Stavudine / Q000009:adverse effects / Q000627:therapeutic use; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D016049:Didanosine; D015224:Dideoxynucleosides; D007328:Insulin; D019259:Lamivudine; D008055:Lipids; D018119:Stavudine; D000099227:Abacavir