title: Changes in bone mineral density after 96 weeks of treatment with atazanavir/ritonavir or lopinavir/ritonavir plus tenofovir DF/emtricitabine in treatment-naive patients with HIV-1 infection: the CASTLE body composition substudy.
abstract: : Antiretroviral therapy initiation is associated with declines in bone mineral density (BMD), which seem greatest with tenofovir disoproxil fumarate (DF)-containing regimens. Data comparing protease inhibitors are limited. This CASTLE substudy compared paired baseline with week 96 BMD in patients initiating tenofovir DF/emtricitabine plus atazanavir/ritonavir (n = 106) vs lopinavir/ritonavir (n = 70). In both groups, week 96 BMD declined significantly in arm, leg, trunk, and total body regions. Atazanavir/ritonavir was associated with smaller 96-week trunk and total body BMD declines compared with lopinavir/ritonavir [multivariate-adjusted least squares mean difference +2.00% (95% confidence interval: 0.52 to 3.45; P = 0.008) and +1.24% (95% confidence interval: 0.13 to 2.35; P = 0.029), respectively]. In addition, low baseline CD4 cell count (<50 cells per microliter) and increasing age were associated with larger declines in BMD.
authors.affiliation: *Chelsea and Westminster Hospital, London, United Kingdom; †Research and Development, Bristol-Myers Squibb, Plainsboro, NJ; ‡Bristol-Myers Squibb, Wallingford, CT; and §Dupont Circle Physicians Group, Washington, DC.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Moyle
authors.forename: Hélène
authors.initials: H
authors.lastname: Hardy
authors.forename: Awny
authors.initials: A
authors.lastname: Farajallah
authors.forename: St John
authors.initials: SJ
authors.lastname: McGrath
authors.forename: Stephen
authors.initials: S
authors.lastname: Kaplita
authors.forename: Douglas
authors.initials: D
authors.lastname: Ward
mesh_terms: D015502:Absorptiometry, Photon; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000069446:Atazanavir Sulfate; D001823:Body Composition; D015519:Bone Density; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D061466:Lopinavir / Q000008:administration & dosage / Q000627:therapeutic use; D015999:Multivariate Analysis; D009842:Oligopeptides / Q000008:administration & dosage / Q000627:therapeutic use; D011725:Pyridines / Q000008:administration & dosage / Q000627:therapeutic use; D019438:Ritonavir / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D009842:Oligopeptides; D011725:Pyridines; D061466:Lopinavir; D000069446:Atazanavir Sulfate; D019438:Ritonavir