Metabolic and anthropometric changes one year after switching from didanosine/stavudine to tenofovir in HIV-infected patients.
BACKGROUND
Nucleoside analogues such as Didanosine and Stavudine are known to cause metabolic and body habitus changes during antiretroviral therapy. The most frequently observed are lactic acidosis, hypercholesterinaemia, hypertriglyceridaemia and lipodystrophy.


METHODS
Over one year we monitored a cohort of 43 patients who switched from either Stavudine, Didanosine or the combination of both to Tenofovir. A group of 11 patients was kept on their original regimen and acted as control group. Blood samples were taken every 3 months from baseline, anthropometric measurements were performed at baseline, after 6 and 12 months.


RESULTS
During observation the levels of lactic acid and cholesterol decreased significantly in the switch group while virologic and immunologic efficacy remained stable. Serum creatinine levels rose significantly in patients switched to Tenofovir, but remained within physiological limits. The mean skin fold thickness increased significantly by 1.8 mm in the switch group after 6 months (p < or =0.001 - p = 0.032).


CONCLUSIONS
These results implicate an improvement of lipid profiles, serum lactate and lipodystrophy in HIV-positive patients after switch to Tenofovir. As a moderate increase in serum creatinine levels was observed, the renal function of patients on a Tenofovir-based regimen should be monitored closely.
Claas
G J
GJ
Medizinische Poliklinik der LMU München, Pettenkoferstrasse 8a, 80336 Münich, Germany. Johannes.Bogner@med.uni-muenchen.de
Jülg
B
B
Goebel
F D
FD
Bogner
Johannes  R
J
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D001835:Body Weight; D018791:CD4 Lymphocyte Count; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D016049:Didanosine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000009:adverse effects / Q000627:therapeutic use*; D010710:Phosphates / Q000097:blood; D012885:Skinfold Thickness; D018119:Stavudine / Q000009:adverse effects / Q000627:therapeutic use*; D000068698:Tenofovir; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood; D019562:Viral Load
D000225:Adenine; D019380:Anti-HIV Agents; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003404:Creatinine; D016049:Didanosine; D006442:Glycated Hemoglobin; D006454:Hemoglobins; D019344:Lactic Acid; D063065:Organophosphonates; D010710:Phosphates; D018119:Stavudine; D000068698:Tenofovir; D014280:Triglycerides; D014527:Uric Acid; C517652:hemoglobin A1c protein, human