title: Impact of switching from lopinavir/ritonavir to atazanavir/ritonavir on body fat redistribution in virologically suppressed HIV-infected adults.
abstract: Changes in body fat distribution in virologically suppressed HIV-infected patients switching from lopinavir/ritonavir (LPV/r) to atazanavir/ritonavir (ATV/r) were assessed. A prospective comparative study was conducted of 37 patients receiving LPV/r regimens switching to ATV/r with 46 patients continuing with LPV/r. Body composition was assessed with whole-body dual-energy x-ray absorptiometry (DXA). Abdominal CT scans were also performed in a subset of patients. Groups were comparable in baseline demographic, clinical, and anthropometric characteristics. After 12 months, peripheral fat did not change significantly, but an increase in trunk fat was observed only in the ATV/r group (0.87 kg, p = 0.021). The percentage of patients with an increase ≥20% in total fat was 37.8% and 15.2% in the ATV/r and LPV/r groups, respectively (p = 0.018). In the ATV/r group, the increase in trunk fat (9.4%) was significantly higher than in peripheral fat (3.7%) (p = 0.007), leading to a significant increase in fat mass ratio (3.76%, p = 0.028), whereas no significant differences were found among LPV/r patients. CT scans showed that abdominal fat increase corresponded to both visceral (28%, p = 0.008) and subcutaneous fat (42%, p = 0.008). These data suggest that switching from LPV/r to ATV/r is associated with increased trunk fat, both subcutaneous and visceral.
authors.affiliation: HIV Unit, Service of Infectious Diseases, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. eferrer@bellvitgehospital.cat
authors.forename: Elena
authors.initials: E
authors.lastname: Ferrer
authors.forename: Luis
authors.initials: L
authors.lastname: del Rio
authors.forename: Esteban
authors.initials: E
authors.lastname: Martínez
authors.forename: Jordi
authors.initials: J
authors.lastname: Curto
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Esteban
authors.initials: E
authors.lastname: Ribera
authors.forename: Eugenia
authors.initials: E
authors.lastname: Negredo
authors.forename: Joaquim
authors.initials: J
authors.lastname: Rosales
authors.forename: Maria
authors.initials: M
authors.lastname: Saumoy
authors.forename: Jordi
authors.initials: J
authors.lastname: Ordóñez
authors.forename: Josep M
authors.initials: JM
authors.lastname: Gatell
authors.forename: Daniel
authors.initials: D
authors.lastname: Podzamczer
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000187:drug effects / Q000378:metabolism; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000494:pharmacology; D000069446:Atazanavir Sulfate; D050218:Body Fat Distribution; D015992:Body Mass Index; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity; D039682:HIV-Associated Lipodystrophy Syndrome / Q000821:virology; D006801:Humans; D061466:Lopinavir / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage / Q000494:pharmacology*; D011446:Prospective Studies; D011725:Pyridines / Q000008:administration & dosage / Q000494:pharmacology*; D019438:Ritonavir / Q000008:administration & dosage / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D009842:Oligopeptides; D011725:Pyridines; D061466:Lopinavir; D000069446:Atazanavir Sulfate; D019438:Ritonavir