title: Predictors of limb fat gain in HIV positive patients following a change to tenofovir-emtricitabine or abacavir-lamivudine.
abstract: BACKGROUND
  Antiretroviral treatment (cART) in HIV causes lipoatrophy. We examined predictors of anthropometric outcomes over 96 weeks in HIV-infected, lipoatrophic adults receiving stable cART randomised to tenofovir-emtricitabine (TDF-FTC) or abacavir-lamivudine (ABC-3TC) fixed dose combinations.
  
  
  RESULTS
  The STEAL study was a prospective trial of virologically suppressed participants randomised to either TDF-FTC (n = 178) or ABC-3TC (n = 179). Anthropometric assessment was conducted at baseline, weeks 48 and 96. The analysis population included those with baseline and week 96 data remaining on randomised therapy. Distribution of limb fat change was divided into four categories (≤ 0%, >0-10%, >10-20%, >20%). Baseline characteristics [demographics, medical history, metabolic and cardiovascular biomarkers] were assessed as potential predictors of change in percent subcutaneous limb fat using linear regression. 303 participants (85% of STEAL population) were included. Baseline characteristics were: mean (± SD) age 45 (± 8) years; thymidine analogue nucleoside reverse transcriptase inhibitor (tNRTI) duration 4 (± 3) years; limb fat 5.4 (± 3.0)kg; body mass index 24.7 (± 3 .5) kg/m(2). Mean (SD) limb fat gain to week 48 and 96 was 7.6% (± 22.4) and 13.2% (± 27.3), respectively, with no significant difference between groups. 51.5% of all participants had >10% gain in limb fat. Predictors of greater limb fat gain at week 96 were baseline tNRTI (10.3, p = 0.001), glucose >6 mmol/L (16.1, p = 0.04), higher interleukin 6 (IL-6) (2.8, p = 0.004) and lower baseline limb fat (3.8-6.4 kg - 11.2; >6.4 kg - 15.7, p trend<0.001).
  
  
  CONCLUSIONS
  Modest peripheral fat gain occurred with both TDF-FTC and ABC-3TC. Baseline factors associated with more severe lipodystrophy (lipoatrophy, baseline tNRTI, raised IL6, and glucose) predicted greater limb fat recovery at 96 weeks.
authors: The Kirby Institute formerly the National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, New South Wales, Australia. ahumphries@kirby.unsw.edu.au
authors: Allison
authors: A
authors: Martin
authors: Janaki
authors: J
authors: Amin
authors: Sean
authors: S
authors: Emery
authors: David
authors: D
authors: Baker
authors: Andrew
authors: A
authors: Carr
authors: David A
authors: DA
authors: Cooper
authors: Mark
authors: M
authors: Bloch
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000273:Adipose Tissue / Q000187:drug effects*; D000328:Adult; D015415:Biomarkers; D050218:Body Fat Distribution; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D015224:Dideoxynucleosides / Q000494:pharmacology* / Q000627:therapeutic use; D004338:Drug Combinations; D000068679:Emtricitabine; D005121:Extremities / Q000473:pathology*; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D019259:Lamivudine / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D063065:Organophosphonates / Q000494:pharmacology* / Q000627:therapeutic use; D011237:Predictive Value of Tests; D000068698:Tenofovir; D000099227:Abacavir
chemical_list: D000225:Adenine; D015415:Biomarkers; D003841:Deoxycytidine; D015224:Dideoxynucleosides; D004338:Drug Combinations; D000068679:Emtricitabine; D019259:Lamivudine; D063065:Organophosphonates; D000068698:Tenofovir; C492871:abacavir, lamivudine drug combination; D000099227:Abacavir