title: Lipid levels and changes in body fat distribution in treatment-naive, HIV-1-Infected adults treated with rilpivirine or Efavirenz for 96 weeks in the ECHO and THRIVE trials.
abstract: BACKGROUND
  Pooled ECHO/THRIVE lipid and body fat data are presented from the ECHO (Efficacy Comparison in Treatment-Naïve, HIV-Infected Subjects of TMC278 and Efavirenz) and THRIVE (TMC278 Against HIV, in a Once-Daily Regimen Versus Efavirenz) trials.
  
  
  METHODS
  We assessed the 96-week effects on lipids, adverse events (AEs), and body fat distribution (dual-energy x-ray absorptiometry) of rilpivirine (RPV) and EFV plus 2 nucleoside/nucleotide reverse transcriptase inhibitors (N[t]RTIs) in treatment-naive adults infected with human immunodeficiency virus type 1 (HIV-1).
  
  
  RESULTS
  Rilpivirine produced minimal changes in total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. Compared with RPV, EFV significantly (P < .001) increased lipid levels. Decreases in the TC/HDL-C ratio were similar with RPV and EFV. Background N[t]RTI affected RPV-induced lipid changes; all levels increased with zidovudine/lamivudine (3TC) and abacavir/3TC (except triglycerides, which were unchanged). With emtricitabine/tenofovir, levels of HDL-C were increased, TC and LDL-C were unchanged, and triglycerides were decreased. With EFV, lipid levels increased in each N[t]RTI subgroup (except triglycerides were unchanged with abacavir/3TC). Fewer (P < .001) RPV-treated patients than EFV-treated patients had TC, LDL-C, and triglyceride levels above National Cholesterol Education Program cutoffs. More RPV- than EFV-treated patients had HDL-C values below these cutoffs (P = .02). Dyslipidemia AEs were less common with RPV than with EFV. Similar proportions of patients had a ≥10% decrease in limb fat (16% with RPV and 17% with EFV). Limb fat was significantly (P < .001) increased to a similar extent (by 12% with RPV and 11% with EFV). At week 96, patients receiving zidovudine/3TC had lost limb fat, and those receiving emtricitabine/tenofovir had gained it.
  
  
  CONCLUSIONS
  Over the course of 96 weeks, RPV-based therapy was associated with lower increases in lipid parameters and fewer dyslipidemia AEs than EFV-based treatment. Body fat distribution changes were similar between treatments. The N[t]RTI regimen affected lipid and body fat distribution changes.
authors.affiliation: University of Pennsylvania, Philadelphia.
authors.forename: Pablo
authors.initials: P
authors.lastname: Tebas
authors.affiliation: Comprehensive Care Center, Fort Lauderdale, Florida.
authors.forename: Michael
authors.initials: M
authors.lastname: Sension
authors.affiliation: Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Arribas
authors.affiliation: Titu Maiorescu University of Medicine and Dr Victor Babes Hospital for Infectious and Tropical Diseases, Bucharest, Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Duiculescu
authors.affiliation: Institute of Tropical Medicine, Antwerp.
authors.forename: Eric
authors.initials: E
authors.lastname: Florence
authors.affiliation: National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.
authors.forename: Chien-Ching
authors.initials: CC
authors.lastname: Hung
authors.affiliation: Weill Cornell Medical College, New York, New York.
authors.forename: Timothy
authors.initials: T
authors.lastname: Wilkin
authors.affiliation: Janssen Infectious Diseases BVBA, Beerse, Belgium.
authors.forename: Simon
authors.initials: S
authors.lastname: Vanveggel
authors.affiliation: Janssen Infectious Diseases BVBA, Beerse, Belgium.
authors.forename: Marita
authors.initials: M
authors.lastname: Stevens
authors.affiliation: Janssen Infectious Diseases BVBA, Beerse, Belgium.
authors.forename: Henri
authors.initials: H
authors.lastname: Deckx
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D048588:Benzoxazines / Q000627:therapeutic use*; D050218:Body Fat Distribution; D003521:Cyclopropanes; D015224:Dideoxynucleosides / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D054303:HIV Reverse Transcriptase / Q000037:antagonists & inhibitors; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D000068696:Rilpivirine / Q000627:therapeutic use*; D000068698:Tenofovir / Q000627:therapeutic use; D055815:Young Adult; D015215:Zidovudine / Q000627:therapeutic use; D000099227:Abacavir
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D015224:Dideoxynucleosides; D004338:Drug Combinations; D054303:HIV Reverse Transcriptase; D019259:Lamivudine; D018894:Reverse Transcriptase Inhibitors; D000068696:Rilpivirine; D000068698:Tenofovir; D015215:Zidovudine; D000099227:Abacavir; C109078:lamivudine, zidovudine drug combination; C098320:efavirenz
keywords: dual-energy x-ray absorptiometry; efavirenz; lipids; lipodystrophy; rilpivirine