title: Improvement of BMD after Switching from Lopinavir/R Plus Two Nucleos(T)ide Reverse Transcriptase Inhibitors to Lopinavir/R Plus Lamivudine: OLE-LIP Substudy.
abstract: To compare 48-week changes in bone mineral density (BMD) and body fat distribution between patients continuing lopinavir/ritonavir and two NRTIs and those switching to lopinavir/ritonavir and lamivudine.
  
  
  
  Substudy of a randomized, open-label, multicenter OLE study was carried out. Adult HIV-infected patients with <50 copies/mL for ≥6 months were randomized (1:1) to continue lopinavir/ritonavir and two NRTIs or switching to lopinavir/ritonavir and lamivudine. Dual-energy X-ray absorptiometry (DXA) was performed at baseline and after 48 weeks to measure bone composition and body fat distribution in both the groups.
  
  
  
  Forty-one patients (dual-therapy, n = 23; triple-therapy, n = 18) of 239, who received at least one dose of study medication, completed the study: median age, 42 years, 71% male, 73% Caucasian. At week 48, total BMD increased by 1.04% (95% CI, 0.06 to 2.01%) among patients switching to dual-therapy, whereas no significant changes occurred in patients maintaining triple-therapy. Dual-therapy and older age were independently associated with total BMD increase. Among patients discontinuing tenofovir-DF, a significant increase was seen in total BMD (1.43; 95% CI, -0.04 to 2.91) and total hip (1.33%; 95% CI, 0.44 to 2.22%). A non-statistically significant decrease in femoral and spinal BMD was observed in patients who discontinued abacavir and in those continuing triple-therapy. Regarding fat distribution, no significant changes were seen in both the treatment groups.
  
  
  
  BMD increased following switching to lopinavir/ritonavir plus lamivudine in HIV-infected patients on suppressive triple-therapy with lopinavir/ritonavir and two NRTIs including tenofovir-DF.
authors.affiliation: a Hospital Universitari Vall d'Hebrón , Autonomous University of Barcelona , Barcelona , Spain.|b Vall d'Hebron Research Institute , Barcelona , Spain.
authors.forename: M
authors.initials: M
authors.lastname: Crespo
authors.affiliation: a Hospital Universitari Vall d'Hebrón , Autonomous University of Barcelona , Barcelona , Spain.|b Vall d'Hebron Research Institute , Barcelona , Spain.
authors.forename: J
authors.initials: J
authors.lastname: Navarro
authors.affiliation: c Hospital Clínic/IDIBAPS , University of Barcelona , Barcelona , Spain.
authors.forename: M
authors.initials: M
authors.lastname: Martinez-Rebollar
authors.affiliation: d Hospital Universitario de Bellvitge , Barcelona , Spain.
authors.forename: D
authors.initials: D
authors.lastname: Podzamczer
authors.affiliation: e Hospital de la Santa Creu i Sant Pau , Barcelona , Spain.
authors.forename: P
authors.initials: P
authors.lastname: Domingo
authors.affiliation: c Hospital Clínic/IDIBAPS , University of Barcelona , Barcelona , Spain.
authors.forename: J
authors.initials: J
authors.lastname: Mallolas
authors.affiliation: d Hospital Universitario de Bellvitge , Barcelona , Spain.
authors.forename: M
authors.initials: M
authors.lastname: Saumoy
authors.affiliation: e Hospital de la Santa Creu i Sant Pau , Barcelona , Spain.
authors.forename: G M
authors.initials: GM
authors.lastname: Mateo
authors.affiliation: a Hospital Universitari Vall d'Hebrón , Autonomous University of Barcelona , Barcelona , Spain.
authors.forename: A
authors.initials: A
authors.lastname: Curran
authors.affiliation: c Hospital Clínic/IDIBAPS , University of Barcelona , Barcelona , Spain.
authors.forename: J
authors.initials: J
authors.lastname: Gatell
authors.affiliation: a Hospital Universitari Vall d'Hebrón , Autonomous University of Barcelona , Barcelona , Spain.
authors.forename: E
authors.initials: E
authors.lastname: Ribera
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015519:Bone Density / Q000187:drug effects*; D001847:Bone Diseases / Q000175:diagnosis* / Q000209:etiology*; D018791:CD4 Lymphocyte Count; D057915:Drug Substitution; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage / Q000009:adverse effects; D061466:Lopinavir / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D019562:Viral Load
chemical_list: D018894:Reverse Transcriptase Inhibitors; D061466:Lopinavir; D019259:Lamivudine
keywords: Bone mineral density; Dual-therapy; Lamivudine; Lipodystrophy; Lopinavir/ritonavir; Switch