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Abstract category: |
B32 Lipodystrophy, metabolic abnormalities,
mitochondrial toxicity, lactic acidosis |
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Abstract title: |
Title: "Long-term changes in body composition
among HIV-infected antiretroviral naïve persons randomized to PI vs.
NNRTI vs. PI + NNRTI-based antiretroviral regimens: Results of the
CPCRA 061 metabolic study" |
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Author(s): |
Gibert C.L.1, Shlay
J.C.2, Bartsch G.3, Peng G.3, Wang
J.4, Visnergarwala F.5, Raghavan
S.6, Xiang Y.3, Farrough M.7, Perry
H.E.8, Grunfeld C.9, El-Sadr W.M.6,
for the Terry Beirn Community Programs for Clinical Research on AIDS
(CPCRA) |
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Institute(s): |
1Wide-Ranging AIDS Program, Veterans
Affairs Medical Center, Washington DC, United States,
2Denver Community Program for Clinical Research on AIDS,
University of Colorado Health Sciences Center, Denver, Colorado,
United States, 3CPCRA Statistical and Data Management
Center, University of Minnesota, Minneapolis, Minnesota, United
States, 4Body Composition Unit of St. Luke's -Roosevelt
Hospital, Columbia University College of Physicians and Surgeons,
New York, New York, United States, 5Houston AIDS Research
Team, Baylor College of Medicine, Houston, Texas, United States,
6Harlem Hospital, Columbia University College of
Physicians and Dentists, New York, New York, United States,
7Wayne State University, Detroit, Michigan, United
States, 8Southern New Jersey AIDS Clinical Trials,
Camden, New Jersey, United States, 9Veterans Affairs
Medical Center, University of California, San Francisco, California,
United States |
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Abstract text: |
Background: Information on long-term changes
in body composition (BC) following initiation of different
antiretroviral treatment (ART) strategies is limited.
Methods: We compared changes in BC in 422 patients
randomized to 1 of 3 treatment strategies: PI (N=141), NNRTI
(N=141), or PI+NNRTI (N=140) containing regimens [with NRTI(s )]. At
baseline and 4-month intervals, fat-free mass (FFM) and total body
fat (TBF) were measured using bioelectric impedance analysis.
Subcutaneous tissue areas (STA) and non-STAs (NSTA) of midarm and
midthigh, and STA and visceral tissue area (VTA) of waist were
calculated from anthropometric measurements. Rates of change
(unit/month) and mean change (unit) were compared by ART strategy.
Results: Median age was 38 years; 22% were women; 60%
African American, and 10% Latino/a. Median follow-up was 5 years.
Rates of change (i.e., slopes) after first follow-up visit were (*
p-value < 0.05):
|
FFM (kg/mo) |
TBF (kg/mo) |
Midarm STA
(cm2/mo) |
Midarm NSTA
(cm2/mo) |
| PI |
0.03* |
0.01 |
-0.12* |
0.11* |
| NNRTI |
0.02* |
-0.02 |
-0.13* |
0.05* |
| PI+NNRTI |
0.02* |
0.00 |
-0.14* |
0.08* |
|
Midthigh STA
(cm2/mo) |
Midarm NSTA
(cm2/mo) |
Waist STA (cm2/mo)
|
Waist VTA (cm2/mo)
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| PI |
-0.15* |
0.06 |
-0.17 |
0.73* |
| NNRTI |
-0.23* |
-0.20* |
-0.39* |
0.58* |
| PI+NNRTI |
-0.25* |
-0.09 |
-0.27* |
0.72* | [
]Neither rates of change nor mean change varied by strategy
group.For all strategies, significant mean increases were observed
in FFM and TBF, and in NSTA of midarm, midthigh, and waist VTA. The
waist STA significantly increased in PI and PI+NNRTI strategies
only. Conclusions: In this prospective trial, changes in
total and regional body fat did not differ by ART strategy, with
losses demonstrated in STAs and gains in FFM, NSTAs, and VTA. In
contradistinction to other studies, there was no significant
difference by planned ART. | |
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