In a multicenter study conducted at Harvard, UC San Francisco and the Universities of Pennsylvania and Indiana, researchers sought to identify baseline characteristics and early on-treatment metabolic changes predictive of lipoatrophy.

Antiretroviral-naive subjects were randomized to nelfinavir (Viracept), efavirenz (Sustiva) or both with ZDV+3TC or ddI+d4T. 95 subjects had baseline lipids and 77 also had week 8 lipids available. One-third had lipoatrophy, defined as >/=20% decrease in limb fat from baseline.

Results

Higher Baseline CD4 Count, body mass index (BMI), increases in triglycerides (TGs) and cholesterol, and treatment with didanosine (Videx) plus stavudine (Zerit) were associated with increased risk for lipoatrophy;

Baseline BMI, CD4 and HIV RNA were not significant predictors for lipoatrophy.

In summary, specific nucleosides, greater baseline CD4 and BMI, but not age, sex or white race were associated with lipoatrophy, as were baseline TGs and cholesterol, but not measures of glucose metabolism.

The authors write, “Increases in TGs and ddI+d4T treatment were associated with lipoatrophy. We did not find evidence of an association between lower nadir CD4+ cell counts and white race with lipoatrophy.”

11/09/05

Reference
R A Parker and others. Baseline and early on-treatment predictors of lipoatrophy at 64 weeks in a randomized trial of initial antiretroviral therapy: a secondary analysis of A5005s, a substudy of ACTG 384. Abstract 4. 7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. November 13-16, 2005, Dublin, Ireland. Antiviral Therapy 2005; 10:L5.