Progression of Lipodystrophy (LD) with continued thymidine analogue usage: Long-term Follow-Up from a randomized clinical trial (The PIILR Study)

A.M. Martin; D. Smith; A. Carr; J. Hoy; J. Chuah; S. Mallal; M. Law; M. Clements; D.A. Cooper

doi:10.1310/0GU7-6X27-MMHE-5ALE

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Progression of Lipodystrophy (LD) with continued thymidine analogue usage: Long-term Follow-Up from a randomized clinical trial (The PIILR Study)

Journal article

Open access

Peer reviewed

Progression of Lipodystrophy (LD) with continued thymidine analogue usage: Long-term Follow-Up from a randomized clinical trial (The PIILR Study)

A.M. Martin, D. Smith, A. Carr, J. Hoy, J. Chuah, S. Mallal, M. Law, M. Clements and D.A. Cooper

HIV Clinical Trials, Vol.5(4), pp.192-200

2004

DOI: https://doi.org/10.1310/0GU7-6X27-MMHE-5ALE

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Abstract

Purpose: During the 24-week PIILR study of protease inhibitor (PI) withdrawal, improved lipids and reduction in intraabdominal visceral fat was seen, however, there was also a loss of subcutaneous limb fat in patients with HIV-lipodystrophy (LD). It was hypothesized that overall improvement in LD may require a longer period of time off PIs. Method: Follow-up of patients randomized to stop or continue PI-based therapy for 24 weeks, in a multicenter study, was continued for up to 120 weeks. Biochemistry and lipid parameters were assessed every 3 months. DEXA and CT scans were performed annually. Limb fat, visceral adipose tissue, and the lipodystrophy case definition score (LCDS) were used as indicators of LD severity. Results: Forty-five male patients with baseline and week 120 body composition data were assessed. There were no significant changes in the limb fat or visceral adipose tissue (VAT) components of LD, with the exception of the LCDS (change from baseline +5.79, p < .001). Control of viral replication was maintained and lipid and glycemic parameters were unchanged over the 120-week follow-up. Linear regression analysis showed on-study usage of stavudine was independently and significantly correlated with both decreased limb fat mass and a higher LCDS. Conclusion: Body composition or metabolic features of LD did not improve over 2 years of observation in patients remaining on predominantly PI-sparing therapy. LD was adversely influenced by continued stavudine use.

Details

Title: Progression of Lipodystrophy (LD) with continued thymidine analogue usage: Long-term Follow-Up from a randomized clinical trial (The PIILR Study)
Authors/Creators: A.M. Martin (Author/Creator) - UNSW Sydney
D. Smith (Author/Creator) - UNSW Sydney
A. Carr (Author/Creator) - St Vincent's Hospital, Melbourne;
J. Hoy (Author/Creator) - The Alfred Hospital
J. Chuah (Author/Creator) - Sexual Health Clinic
S. Mallal (Author/Creator) - Royal Perth Hospital
M. Law (Author/Creator) - UNSW Sydney
M. Clements (Author/Creator) - UNSW Sydney
D.A. Cooper (Author/Creator) - UNSW Sydney
Publication Details: HIV Clinical Trials, Vol.5(4), pp.192-200
Publisher: Thomas Land Publishers Inc.
Identifiers: 991005543194007891
Copyright: © 2004 Thomas Land Publishers, Inc.
Murdoch Affiliation: Centre for Clinical Immunology and Biomedical Statistics
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.66 HIV; 1.66.1372 HIV Comorbidities
Web Of Science research areas: Infectious Diseases; Pharmacology & Pharmacy
ESI research areas: Clinical Medicine