my personal edition > aids and hiv > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Switching From Zidovudine- to Tenofovir-Based Therapy Preserves and Recovers Limb Fat in Patients With Human Immunodeficiency Virus: Presented at CROI

By Maria Bishop

BOSTON, MA -- February 6, 2008 -- Patients with HIV who switch from a fixed-dose combination of zidovudine plus lamivudine tablets to a fixed-dose combination of tenofovir plus emtricitabine tablets while receiving efavirenz are able to preserve limb fat and achieve limb-fat recovery, according to researchers reporting here at the 15th Conference on Retroviruses and Opportunistic Infections (CROI).

Thymidine analogues such as zidovudine (AZT) commonly lead to lipoatrophy in patients with HIV and are therefore not recommended as initial therapy, according to lead author Graeme Moyle, MD, MBBS, Director, HIV Research Strategy, and Associate Specialist in HIV/GU Medicine, Chelsea and Westminster Hospital, London, United Kingdom. Dr. Moyle presented the study findings on February 4.

In the 48-week, open-label, multicenter Simplification With Easier Emtricitabine and Tenofovir (SWEET) study, 117 subjects were given at least one daily dose of the study drugs (234 total doses).

A dual-energy x-ray absorptiometry substudy led by Dr. Moyle assessed whether the use of tenofovir/emtricitabine (n = 46) leads to improved fat recovery and fat sparing compared with AZT-based therapy (n = 54).

At 48 weeks, the median total limb fat (kg) and whole body fat (kg) in tenofovir/emtricitabine patients had undergone positive changes from baseline, while that of the zidovudine/lamivudine patients had decreased. An earlier switch to tenofovir/emtricitabine, the authors noted, led to greater limb-fat increase.

Dr. Moyle and colleagues also sought to determine whether there was a change in bone-mineral density (BMD) in the lumbar spine and pelvic parameters with tenofovir/emtricitabine compared with AZT-based therapy. At the end of the substudy, there were no significant changes in lumbar spine or pelvic BMD, although overall BMD was preserved.

Based on these findings, the authors stated that patients did not have an increased relative risk of fracture due to study drugs at 48 weeks.

They concluded that tenofovir/emtricitabine maintains virologic control while preserving renal function, BMD, and limb fat.

In the United States, the components of Truvada and Sustiva are available in a fixed-dose combination tablet called Atripla(R) (efavirenz 600mg / emtricitabine 200mg / tenofovir disoproxil fumarate 300 mg). Atripla is currently the first and only once-daily single tablet regimen approved for the treatment of HIV-1 infection in adults either as stand-alone therapy or in combination with other antiretroviral agents.


[Presentation title: Switching From Combivir to Truvada Preserves Limb Fat: Results of a DEXA Sub-Study of a 48-Week Randomized Study. Abstract 960]

E-Mail this DGDispatch to a colleague

To print, use this version