Lafon E, Michon C, Bani Sadr F, Chandemerle C, Melchior JC, de Truchis P, Gregoire V, Perraud P, Carlier R, Landman R, Quertainmont Y, Beumont Mauviel M; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. WePeB4256.
E. Lafon, CISIH 92, Hopital Louis Mourier, 178 Rue des Renouillers, 92700 Colombes, France, Tel.: +33 147 606 057, Fax: +33 147 606 239, E-mail: christine.chandemerle@lmr.ap-hop-paris.fr
Objective: To examine the benefits of switching from PI to EFV on clinical signs of LD, blood lipids and glucose (GLC), VAT and SAT, in virologically controlled patients. Methods: PI was replaced by EFV in patients with first line HAART, viral load (VL) > 200 copies/ml and, at least 2 clinical signs of LD and/or at least one biochemical abnormality such as GLC intolerance, diabetes mellitus, hypertriglyceridemia. Anthropometric measures, VL, CD4 cells count, triglycerids (TG), cholesterol (CHOL) and glycaemia (GLY) were determined at baseline (BL) and every 2 months. The VAT, SAT and VAT/TAT (total adipose tissue) were evaluated by CT scan or MRI at BL and at week 24 (W24). Results: 17/25 patients (6 F/11 M) completed the W24. All maintained VL >200 copies/ml. The median CD4 did not significantly rise (BL/W24 : 526/548/mm3). 50% of patients presented a subjective improvement of clinical signs of LD. No significant changes were observed in anthropometric measures. No significant decrease of blood lipids and GLC occurred : mean TG (BL/ W24 : 2,9/3,05 mmol/l), mean CHOL (BL/W24 : 6,78/6,42 mmol/l) and mean GLY (BL/W24 : 5,79/5,66 mmol/l). CT scan or MRI (14/17) results showed no significant improvement: mean VAT (BL/ W24 :113,1 cm2 `SD 59.2'/109.1 cm2 `SD 50.6'), mean SAT (BL/W24 : 108,6 cm2 `SD 59.3'/107 cm2 `SD 45.5'), mean VAT/TAT (BL/ W24 : 0.51 `SD 0.16'/0.50 `SD 0.15'). Among women (n = 5) VAT/TAT was >0,4 in all cases but the SAT was high (mean SAT : BL/ W24 : 126,4 cm2 `SD 54.2'/128.1 cm2 `SD 44.1'). This data suggests that VAT/TAT rate might not be an appropriate parameter to evaluate women fat redistribution. Conclusions: Substitution of PI by EFV maintained virological control but no significant improvement has been observed in anthropometric measures, in fasting lipids and GLC. Despite no changes in VAT, SAT and VAT/TAT at W24, subjective improvement in the morphologic appearance occurred among 50% of patients. Longer follow-up is necessary.
Publication Types:
Keywords:
- Adipose Tissue
- Antiretroviral Therapy, Highly Active
- Female
- Gene Products, tat
- HIV-1
- Humans
- Lipids
- Lipodystrophy
- Magnetic Resonance Imaging
- Oxazines
- Protease Inhibitors
- Thoracic Surgery, Video-Assisted
- Tomography, X-Ray Computed
- Viral Load
- efavirenz
- radiography
Other ID:
UI: 102240468
From Meeting Abstracts