title: A 48-week study of fat molecular alterations in HIV naive patients starting tenofovir/emtricitabine with lopinavir/ritonavir or efavirenz.
abstract: BACKGROUND
  Conflicting reports on the effects of efavirenz (EFV) and lopinavir/ritonavir (LPV/r) on subcutaneous adipose tissue (SAT) have been described.
  
  
  OBJECTIVE
  The aim was to assess the 48-week molecular and clinical effects of LPV/r and EFV, combined with tenofovir/emtricitabine (TDF/FTC), on SAT of HIV-infected, antiretroviral-naive patients.
  
  
  METHODS
  Forty-four adults were started on LPV/r or EFV combined with TDF/FTC. Fasting metabolic tests, HIV RNA, CD4 cell count, and fat measured by dual x-ray absorptiometry scans were obtained at study entry and week 48. Mitochondrial DNA (mtDNA) and transcripts for mtDNA-encoded proteins and genes involved in inflammation, adipocyte differentiation, and metabolism were assessed in paired SAT biopsies.
  
  
  RESULTS
  Whole-body fat and limb fat mass increased in the LPV/r and EFV groups. MtDNA and cytochrome oxidase subunit II did not change, and cytochrome b increased significantly in EFV-treated patients. Tumor necrosis factor alpha and monocyte chemotactic protein-1 gene expression did not change in the LPV/r group, but these significantly increased in the EFV group. Interleukin 18 decreased in the LPV/r group, whereas it increased in the EFV group.
  
  
  CONCLUSIONS
  Starting TDF/FTC plus EFV was associated with an increased expression of genes encoding for inflammatory cytokines in SAT in naive patients. Therapy with TDF/FTC plus LPV/r or EFV was associated with an increase in subcutaneous fat mass.
authors.affiliation: *Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; †Department of Biochemistry and Molecular Biology, Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain; ‡CIBER Fisiopatologia de la Obesidad y Nutrición, Barcelona, Spain; §Biostatistics and Data Management Platform, IDIBAPS, Hospital Clinic; Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; and ‖Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitari Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Maria del Mar
authors.initials: Mdel M
authors.lastname: Gutierrez
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Gallego-Escuredo
authors.forename: Ferran
authors.initials: F
authors.lastname: Torres
authors.forename: Maria Gracia
authors.initials: MG
authors.lastname: Mateo
authors.forename: Joan
authors.initials: J
authors.lastname: Villarroya
authors.forename: Karuna
authors.initials: K
authors.lastname: Lamarca
authors.forename: Joan Carles
authors.initials: JC
authors.lastname: Domingo
authors.forename: Francesc
authors.initials: F
authors.lastname: Vidal
authors.forename: Francesc
authors.initials: F
authors.lastname: Villarroya
authors.forename: Marta
authors.initials: M
authors.lastname: Giralt
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000480:Alkynes; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D048588:Benzoxazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003521:Cyclopropanes; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000068679:Emtricitabine; D005786:Gene Expression Regulation / Q000187:drug effects; D015658:HIV Infections / Q000188:drug therapy*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000378:metabolism; D006801:Humans; D061466:Lopinavir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D063065:Organophosphonates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D019438:Ritonavir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D050151:Subcutaneous Fat / Q000187:drug effects*; D000068698:Tenofovir; D059467:Transcriptome
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D063065:Organophosphonates; D003841:Deoxycytidine; D061466:Lopinavir; D000068698:Tenofovir; D000068679:Emtricitabine; D000225:Adenine; C098320:efavirenz; D019438:Ritonavir