Several studies suggest that longer-term use of stavudine (Zerit) is associated with lipodystrophy. There appears to be a modest improvement in signs of lipoatrophy a year following a switch from stavudine to tenofovir (Viread). However, it is not known if the beneficial effect continues in the second year after the switch.

To explore any changes in the second year after switching, researchers conducted a study in 10 patients all of whom received a stavudine-containing regimen for at least one year

In all 10 patients, stavudine was replaced by tenofovir, without other medication changes. The patients were assessed at baseline and weeks 48 and 96 by dual energy X-ray absorptiometry (DEXA). Bone mineral content (BMC), fat (FAT) and lean body mass (LEAN) were evaluated for whole body as well as regionally (arms, legs, trunk).

Results

See Table 1 for results.

Based on these findings, the study authors conclude, “In a group of HIV-infected individuals with lipoatrophy, replacing stavudine with tenofovir resulted in a modest but significant improvement in lipoatrophy after 48 weeks of treatment.”

“The beneficial effect of switching on fat mass was maintained during the second year of treatment, but no further improvement was noticed.”

12/09/05

Reference
G Tsekes and others. Body composition changes in HIV-infected patients with lipoatrophy 1 and 2 years after switching from stavudine to tenofovir disoproxil fumarate. Abstract 40. 7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. November 13-16, 2005. Dublin, Ireland. Antiviral Therapy 2005; 10:L26.