UNIGE document Scientific Article
previous document  unige:20818  next document
add to browser collection
Title

No significant effect of uridine or pravastatin treatment for HIV lipoatrophy in men who have ceased thymidine analogue nucleoside reverse transcriptase inhibitor therapy: a randomized trial

Authors
Bloch, M.
Wand, H.
Delhumeau, C.
Finlayson, R.
Rafferty, M.
Norris, R.
show hidden authors show all authors [1 - 10]
Published in HIV Medicine. 2010, vol. 11, no. 8, p. 493-501
Abstract BACKGROUND: Lipoatrophy can complicate thymidine analogue nucleoside reverse transcriptase inhibitor (tNRTI)-based antiretroviral therapy (ART). Lipoatrophy may be less likely with ART including ritonavir-boosted lopinavir (LPV/r). Small, placebo-controlled studies found that uridine (in tNRTI recipients) and pravastatin improved HIV lipoatrophy over 12 weeks. Today, most patients with lipoatrophy receive non-tNRTI-based ART; the effect of uridine in such patients is unknown. METHODS: We performed a prospective, randomized trial in lipoatrophic adults with plasma HIV RNA<50 HIV-1 RNA copies/mL on tNRTI-sparing ART including LPV/r. Patients received uridine [36 g three times a day (tid) on 10 consecutive days per month; n=10], pravastatin [40 mg every night (nocte); n=12], uridine plus pravastatin (n=11) or neither (n=12) for 24 weeks. The primary endpoint was mean change in limb fat mass as assessed by dual-energy X-ray absorptiometry (DEXA). With 20 patients per intervention, the study had 80% power to detect a mean difference between a treatment and the control of 0.5 kg, assuming a standard deviation of 0.9 and an alpha threshold equal to 5% (two-sided). RESULTS: Of 45 participants (all men, with median age 49.5 years and median limb fat 2.6 kg), two discontinued pravastatin and one participant stopped both pravastatin and uridine. The difference between the mean changes in limb fat mass for uridine vs. no uridine was 0.03 kg [95% confidence interval (CI) -0.35, +0.28; P=0.79]. The respective difference for pravastatin was -0.03 kg (95% CI -0.29, +0.34; P=0.84). Pravastatin slightly decreased total cholesterol (0.44 mmol/L; P=0.099). Visceral adipose tissue measured by computed tomography did not change significantly. CONCLUSION: In this population and at the doses used, neither uridine nor pravastatin for 24 weeks significantly increased limb fat mass.
Keywords Absorptiometry, PhotonAdiposity/drug effectsAdultAnti-Retroviral Agents/adverse effects/*therapeutic useAnticholesteremic Agents/pharmacokinetics/pharmacology/*therapeutic useDideoxynucleosides/adverse effectsDrug Therapy, CombinationExtremitiesHIV Infections/complications/drug therapyHIV-Associated Lipodystrophy Syndrome/chemically induced/*drug therapyHumansLopinavirMaleMiddle AgedPravastatin/pharmacokinetics/pharmacology/*therapeutic usePyrimidinones/therapeutic useReverse Transcriptase Inhibitors/adverse effectsRitonavir/therapeutic useUridine/pharmacokinetics/pharmacology/*therapeutic use
Identifiers
PMID: 20236365
Full text
Structures
Research group Unité HIV (46)
Citation
(ISO format)
CALMY, Alexandra et al. No significant effect of uridine or pravastatin treatment for HIV lipoatrophy in men who have ceased thymidine analogue nucleoside reverse transcriptase inhibitor therapy: a randomized trial. In: HIV Medicine, 2010, vol. 11, n° 8, p. 493-501. https://archive-ouverte.unige.ch/unige:20818

117 hits

0 download

Update

Deposited on : 2012-05-23

Export document
Format :
Citation style :