Journal Article

Improvement in Lipoatrophy Associated with Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus—Infected Patients Switched from Stavudine to Abacavir or Zidovudine: The Results of the TARHEEL Study

Grace A. McComsey, Douglas J. Ward, Siegrid M. Hessenthaler, Michael G. Sension, Peter Shalit, J. Tyler Lonergan, Robin L. Fisher, Vanessa C. Williams and Jaime E. Hernandez

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 2, pages 263-270
Published in print January 2004 | ISSN: 1058-4838
Published online January 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/380790
Improvement in Lipoatrophy Associated with Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus—Infected Patients Switched from Stavudine to Abacavir or Zidovudine: The Results of the TARHEEL Study

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Stavudine use is a contributing factor for lipoatrophy, whereas use of abacavir or zidovudine is less likely to cause this complication. The TARHEEL study was a 48-week, open-label study that assessed changes in lipoatrophy after abacavir (86 patients [73%]) or zidovudine (32 patients [27%]), 300 mg twice daily, was substituted for stavudine for 118 human immunodeficiency virus (HIV)–infected patients (HIV type 1 RNA level, <400 copies/mL) with virological suppression who had developed lipoatrophy after ⩾6 months of stavudine-based treatment. At week 48, full-body dual-energy x-ray absorptiometry demonstrated a median increase in arm fat of 35%, leg fat of 12%, and trunk fat of 18%, compared with the baseline level. These improvements coincided with fat gain in lipoatrophic areas that was documented by computerized tomography. Results of a “body image” questionnaire showed that a substantial percentage of patients reported some or a lot of fat gain in the arms (22%), legs (18%), buttocks (19%), and face (27%). HIV suppression was maintained over the study period. In conclusion, replacing stavudine with abacavir or zidovudine resulted in improvement in stavudine-induced lipoatrophy.

Journal Article.  4237 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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