title: Changes in body composition and mitochondrial DNA in HIV-1-infected patients switching to fixed-dose abacavir/lamivudine or tenofovir/emtricitabine: a substudy of the BICOMBO trial.
abstract: BACKGROUND
  Fat distribution, bone mineral density (BMD) and mitochondrial DNA (mtDNA) may improve, in the long-term, after switching from nucleoside reverse transcriptase inhibitors (NRTIs) to fixed-dose abacavir (ABC)/lamivudine (3TC) or tenofovir (TDF)/emtricitabine (FTC).
  
  
  METHODS
  This was a prospective, randomized, open-label, multicentre substudy of the BICOMBO trial in which virologically suppressed patients had their NRTIs switched to ABC/3TC or TDF/FTC. Whole-body dual-energy X-ray absorptiometry (DXA) was used to measure limb, trunk and total body fat and total BMD. Lumbar and hip DXA scans were used to measure lumbar and hip BMD. Fat mass ratio (FMR; % trunk fat/% leg fat by whole-body DXA) was used to assess fat distribution. mtDNA was measured in peripheral blood mononuclear cells (PBMCs). Parameters of interest were measured at baseline, 48 and 96 weeks, and were compared between treatment groups.
  
  
  RESULTS
  Of 56 patients included, 45 (20 ABC/3TC and 25 TDF/FTC) completed the substudy. After 96 weeks, ABC/3TC (+756 g, +12.1%) and TDF/FTC (+337 g, +7.6%) led to non-significantly different increases in limb fat (P=0.60). By contrast, trunk fat showed a significant increase (P=0.04) with ABC/3TC (+1,184 g, +10.6%) relative to TDF/FTC (-370 g, -4.2%). Median (IQR) FMR remained unchanged with ABC/3TC (-0.01 [-0.16-0.06]; P=0.23), but it decreased significantly with TDF/FTC (-0.13 [-0.30-0.00]; P=0.007). Total BMD and mtDNA significantly increased after 96 weeks, without differences between groups.
  
  
  CONCLUSIONS
  Switching from NRTIs to either ABC/3TC or TDF/FTC led to similar increases in limb fat, BMD and PBMC mtDNA after 96 weeks.
authors.affiliation: Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. acurran@vhebron.net
authors.forename: Adrian
authors.initials: A
authors.lastname: Curran
authors.forename: Esteban
authors.initials: E
authors.lastname: Martinez
authors.forename: Daniel
authors.initials: D
authors.lastname: Podzamczer
authors.forename: Montserrat
authors.initials: M
authors.lastname: Lonca
authors.forename: Patricia
authors.initials: P
authors.lastname: Barragan
authors.forename: Manuel
authors.initials: M
authors.lastname: Crespo
authors.forename: Vicenç
authors.initials: V
authors.lastname: Falco
authors.forename: Sergio
authors.initials: S
authors.lastname: Vidal-Sicart
authors.forename: Arkaitz
authors.initials: A
authors.lastname: Imaz
authors.forename: Maria
authors.initials: M
authors.lastname: Martinez
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Gatell
authors.forename: Esteban
authors.initials: E
authors.lastname: Ribera
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001823:Body Composition / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects; D004272:DNA, Mitochondrial / Q000235:genetics; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015224:Dideoxynucleosides / Q000627:therapeutic use*; D004338:Drug Combinations; D000068679:Emtricitabine; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D000068698:Tenofovir; D000099227:Abacavir
chemical_list: D000225:Adenine; D019380:Anti-HIV Agents; D004272:DNA, Mitochondrial; D003841:Deoxycytidine; D015224:Dideoxynucleosides; D004338:Drug Combinations; D000068679:Emtricitabine; D019259:Lamivudine; D063065:Organophosphonates; D000068698:Tenofovir; C492871:abacavir, lamivudine drug combination; D000099227:Abacavir