Role of Long-Term Nucleoside-Analogue Therapy in Lipodystrophy and Metabolic Disorders in Human Immunodeficiency Virus—Infected Patients

• Published in: Clinical infectious diseases 2002-03, Vol.34 (5), p.649-657
• Main Authors: Chêne, Geneviève, Angelini, Emmanuelle, Cotte, Laurent, Lang, Jean-Marie, Morlat, Philippe, Rancinan, Corinne, May, Thierry, Journot, Valérie, Raffi, François, Jarrousse, Bernard, Grappin, Michèle, Lepeu, Gérard, Molina, Jean-Michel
• Format: Article
• Language: English
• Subjects: Adult; AIDS; Anti-HIV Agents - adverse effects; Anti-HIV Agents - therapeutic use; Antiretrovirals; Biological and medical sciences; Drug Therapy, Combination; Drug toxicity and drugs side effects treatment; Fats; Female; Follow-Up Studies; HIV Infections - complications; HIV Infections - drug therapy; HIV/AIDS; Humans; Lipid metabolism; Lipodystrophy; Lipodystrophy - chemically induced; Lipodystrophy - etiology; Male; Medical sciences; Memory interference; Metabolic Diseases - chemically induced; Metabolic Diseases - etiology; Miscellaneous (drug allergy, mutagens, teratogens...); Multivariate Analysis; Nucleosides; Nucleosides - adverse effects; Nucleosides - therapeutic use; Pharmacology. Drug treatments; Protease inhibitors; RNA; Triglycerides
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/338811

The role of nucleoside analogues (NAs) in lipodystrophy (LD) syndrome in human immunodeficiency virus (HIV)-infected patients remains controversial. We studied the prevalence of LD in previously untreated patients randomized to receive different NA combinations (in the ALBI-ANRS 070 trial) for 6 months. At month 30 of follow-up, 37 (31%) of 120 patients had ≥1 morphologic change, and 21 (57%) of 37 had isolated peripheral lipoatrophy; corresponding values for the patients who received only NAs throughout follow-up were 20 (30%) of 66 and 14 (67%) of 21, respectively. In multivariate analysis, factors associated with presence of LD at month 30 were initial assignment to the group receiving stavudine and didanosine (odds ratio [OR], 6.7; P = .02), age (OR for being 10 years older, 3.6; P = .002), and HIV RNA level at month 30 (OR, 0.4; P = .007). No difference was observed in cholesterol and glucose levels as a function of any pattern of antiretroviral exposure. Exposure to stavudine and didanosine was associated with LD syndrome (predominantly lipoatrophy).