title: Effects of discontinuing stavudine or protease inhibitor therapy on human immunodeficiency virus-related fat redistribution evaluated by dual-energy x-ray absorptiometry.
abstract: OBJECTIVE
  To determine whether discontinuation of stavudine or protease inhibitor therapy improves human immunodeficiency virus (HIV)-related fat distribution in men.
  
  
  METHODS
  Observational, retrospective study consisting of a cross-sectional (part 1) and a longitudinal (part 2) study.
  
  
  METHODS
  Medical records from Purpan University Hospital and La Grave University Hospital, Toulouse, France. Subjects. Eighty men with HIV infection treated with antiretrovirals and 151 healthy male controls matched for age.
  
  
  RESULTS
  In part 1, body composition and fat distribution of the HIV-infected men were compared by dual energy x-ray absorptiometry (DEXA) with those of the controls to determine whether body fat distribution is altered in HIV-infected men. In part 2, we analyzed modifications of body composition and fat distribution in 45 of the 80 patients. These 45 had been exposed to antiretroviral drugs, including stavudine and a protease inhibitor, for at least 5 months before the first of two DEXA assessments. They received three different treatment strategies for several months. In group 1, stavudine was withdrawn; in group 2, protease inhibitor was discontinued, and in group 3, stavudine plus protease inhibitor were continued. Group 1 showed a significant fat gain in the lower extremities 31.7 +/- 5.9 months after stavudine discontinuation (p<0.0001). Group 2 did not show any significant modification of total body, lower limb, or trunk fat despite protease inhibitor discontinuation for 35.2 +/- 6.6 months. Findings were similar for group 3, who continued receiving stavudine-protease inhibitor therapy for 21.2 +/- 12.8 months.
  
  
  CONCLUSIONS
  These data suggest that long-term withdrawal of stavudine from the antiretroviral therapy regimen may be associated with significant improvement in lipoatrophy in the lower extremities, whereas long-term protease inhibitor withdrawal did not modify fat distribution.
authors.affiliation: Service de Pharmacologie Clinique, Cent re Midi-Pyrénées de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Faculté de Médecine, Hôpitaux de Toulouse, Toulouse, France. neda67@yahoo.com
authors.forename: Neda
authors.initials: N
authors.lastname: Tavassoli
authors.forename: Haleh
authors.initials: H
authors.lastname: Bagheri
authors.forename: Agnes
authors.initials: A
authors.lastname: Sommet
authors.forename: Cyrille
authors.initials: C
authors.lastname: Delpierre
authors.forename: Fabrice
authors.initials: F
authors.lastname: Marion-Latard
authors.forename: Patrice
authors.initials: P
authors.lastname: Massip
authors.forename: Christian
authors.initials: C
authors.lastname: Aquilina
authors.forename: Eric
authors.initials: E
authors.lastname: Bonnet
authors.forename: Martine
authors.initials: M
authors.lastname: Obadia
authors.forename: Eric
authors.initials: E
authors.lastname: Labau
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Montastruc
authors.forename: Jacques
authors.initials: J
authors.lastname: Bernard
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000502:physiology*; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001823:Body Composition / Q000187:drug effects; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology*; D017320:HIV Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D039682:HIV-Associated Lipodystrophy Syndrome / Q000188:drug therapy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018119:Stavudine / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018119:Stavudine