Lipodystrophy in people who start treatment with a protease-sparing regimen may be more frequent than randomised studies have suggested, according to the results of a Spanish prospective cohort reported this week at the Sixth International Congress on Drug Therapy in HIV Infection in Glasgow.
Eleven per cent of 166 individuals who started treatment with either a triple nucleoside analogue or non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen developed body fat changes during a mean follow-up period of 14.5 months. The incidence of lipodystrophy, determined by clinician and patient report, was 7.49 cases per 100 patient years of follow-up.
In contrast the DMP-006 study found an incidence of 0.5% - 2.5% in both PI-sparing and nucleoside analogue-sparing arms of the study, a large trial that compared AZT/3TC/efavirenz, AZT/3TC/indinavir and indinavir/efavirenz over 48 weeks.
The Spanish group reported that the main risk factors for lipodystrophy by multivariate analysis were age over 45 years (RH13.36) and baseline fasting triglycerides > 200mg/dL (RH 14.88).
References
Martinez E et al. A prospective cohort study on the risk of lipodystrophy in HIV-1 infected patients who have never received protease inhibitors. Sixth International Congress on Drug Therapy in HIV Infection, Glasgow, abstract P145, 2002.