Document Detail


Switching to lopinavir/ritonavir with or without abacavir/lamivudine in lipoatrophic patients treated with zidovudine/abacavir/lamivudine.
MedLine Citation:
PMID:  23386261     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Discontinuation of thymidine nucleoside reverse transcriptase inhibitors (tNRTIs) is the only proven strategy for improving lipoatrophy. It is unclear whether switching to NRTI-sparing or to non-thymidine NRTI-containing therapy has differential effects on body fat recovery. METHODS: This was a 96 week, open-label, randomized study in suppressed patients with moderate/severe lipoatrophy and no prior virological failure while receiving a protease inhibitor and who had their triple NRTI regimen (zidovudine/lamivudine/abacavir) switched to lopinavir/ritonavir plus abacavir/lamivudine for a 1 month run-in period and then randomized to lopinavir/ritonavir plus abacavir/lamivudine versus lopinavir/ritonavir monotherapy. The KRETA trial is registered with ClinicalTrials.gov (number NCT00865007). RESULTS: Of 95 patients included, 88 were randomized to lopinavir/ritonavir plus abacavir/lamivudine (n = 44) or lopinavir/ritonavir monotherapy (n = 44). Median (IQR) baseline limb fat was 2.5 (1.6-3.7) kg in the lopinavir/ritonavir plus abacavir/lamivudine group and 2.5 (2.0-5.4) kg in the lopinavir/ritonavir monotherapy group. Six patients in the triple therapy group and 13 in the monotherapy group had discontinued study drugs by week 96. Although there were limb fat gains in each group at weeks 48/96 (+324/+358 g in lopinavir/ritonavir plus abacavir/lamivudine, P = 0.09/0.07, versus +215/+416 g in the lopinavir/ritonavir monotherapy group, P = 0.28/0.16), differences between groups were not significant [difference +109 g (95% CI -442, +660)/-57 g (95% CI -740, +625)]. CONCLUSIONS: In lipoatrophic patients treated with zidovudine/lamivudine/abacavir, switching to lopinavir/ritonavir monotherapy had no additional benefit in limb fat recovery relative to switching to lopinavir/ritonavir with abacavir/lamivudine. These data suggest that non-thymidine nucleosides such as abacavir/lamivudine are not an obstacle to limb fat recovery.
Authors:
J I Bernardino; F Pulido; E Martinez; J Arrizabalaga; P Domingo; J Portilla; A Ocampo; J Muñoz; R Torres; J R Arribas;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-5
Journal Detail:
Title:  The Journal of antimicrobial chemotherapy     Volume:  -     ISSN:  1460-2091     ISO Abbreviation:  J. Antimicrob. Chemother.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513617     Medline TA:  J Antimicrob Chemother     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
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Investigator
Investigator/Affiliation:
José I Bernardino / ; José R Arribas / ; Juan González-García / ; Jose M Peña / ; M Luisa Montes / ; Juan Miguel Castro / ; Rocío Campos / ; Federico Pulido / ; Rafael Rubio / ; Jara Llenas / ; Silvana Fiorante / ; Mariano Matarranz / ; Natalia Ortiz / ; Rafael Torres / ; Juan José Jusdado / ; Miguel Cervero / ; José Luis Agud / ; Antonio Rivero / ; Julian de la Torre-Cisneros / ; Jose M Kindelán / ; Rafael Jurado / ; Milagros García-Lázaro / ; Angela Camacho / ; Esteban Martinez / ; Laura Zamora / ; Mariano Larrousse / ; Montserrat Loncá / ; Jose Maria Gatell / ; Pere Domingo / ; M Antonia Sambeat / ; Maria Del Mar Gutierrez / ; Gracia Maria Mateo / ; Josefa Muñoz / ; Oscar Ferrero / ; Sofía Ibarra / ; Zurine Zubero / ; Juan Miguel Santamaría / ; Nekane Juaristi / ; Josu Baraiaetxaburu / ; Julio Arrizabalaga / ; Miguel Angel Goneaga / ; Francisco Rodriguez-Arrondo / ; Miguel A Von Wichmann / ; Jose A Iribarren / ; M J Bustinduy / ; Maialen Ibarguren / ; Ioana Riaño / ; Antonio Ocampo / ; Alfredo Rodriguez Da Silva / ; Maite Perez / ; Celia Miralles / ; Joaquin Portilla / ; Livia Giner /

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