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Body
Composition and Metabolic Changes in Treatment-naive HIV Patients
Randomized to Didanosine and Stavudine vs. Abacavir and Lamivudine
Comparisons of body
composition and metabolic changes among antiretroviral-naive
patients randomly assigned to didanosine
(Videx) and stavudine
(Zerit)-- (ddI + d4T) vs. abacavir
(Ziagen) and lamivudine
(Epivir)- (ABC + 3TC) containing regimens were assessed
in a nested substudy of an ongoing multicenter randomized trial.
At
baseline and every 4 months, body cell mass and total body fat were
calculated, anthropometric measurements were performed, and fasting
metabolic parameters were obtained.
The
rates of change (unit/mo) estimated using the slopes of regression
lines and overall mean changes from baseline were compared by study
assignment. Among 96 patients enrolled, 46 received ddI + d4T- and
50 received ABC + 3TC-containing regimens with a median follow-up
of 32.4 months.
For
both study arms, an overall increase in the rates of change was
seen for body cell mass. For ddI + d4T, after an initial increase,
the rates of change declined for regional fat and total body fat
compared with an increase for ABC + 3TC, with the 2 arms being significantly
different (P < 0.05).
For
high-density lipoprotein cholesterol
rates of change, ddI + d4T decreased, while ABC + 3TC increased.
For both arms, low-density lipoprotein cholesterol decreased, while
triglycerides
increased.
Early
and sustained increases in insulin
and insulin resistance were seen only for ddI + d4T.
In this prospective study, metabolic and body composition changes
varied according to whether subjects received ddI + d4T or ABC +
3TC.
02/09/05
Reference
J C Shlay and others (for the Terry Beirn Community Programs
for Clinical Research on AIDS (CPCRA). Body Composition and Metabolic
Changes in Antiretroviral-Naive Patients Randomized to Didanosine
and Stavudine vs. Abacavir and Lamivudine. Journal of Acquired Immune Deficiency Syndromes 38(2): 147-155.
February 1, 2005.
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