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Rigo-Bonnin R, García-Tejada L, Mas-Bosch V, Imaz A, Manuel Tiraboschi J, Scévola S, Niubó J, Navarro-Alcaraz A, Podzamczer D. Development and validation of equilibrium dialysis UHPLC-MS/MS measurement procedures for total and unbound concentrations of bictegravir, dolutegravir, darunavir and doravirine in human plasma. Application to patients with HIV. Clin Chim Acta 2024; 552:117678. [PMID: 38042460 DOI: 10.1016/j.cca.2023.117678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/03/2023] [Accepted: 11/20/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Fixed-dose combinations of antiretroviral drugs are commonly used to treat HIV infection and therapeutic monitoring is not part of routine clinical practice. However, drug concentrations monitoring might have role in different clinical scenarios as well as for research purposes. This study aimed to develop and validate UHPLC-MS/MS procedures for measuring total and unbound concentrations of bictegravir, dolutegravir, darunavir and doravirine in human plasma. MATERIAL AND METHODS Equilibrium dialysis preceded sample preparation (based on protein precipitation) for measuring unbound antiretroviral concentrations. Chromatographic separations were achieved on an Acquity®-UPLC® HSS™-T3 column (50 mm × 2.1 mm; 1.8 µm) using a non-linear water/acetonitrile gradient containing 0.1 % formic acid at a 0.5 mL/min flow rate. Antiretrovirals were detected by tandem mass spectrometry in positive electrospray ionisation and multiple reaction monitoring modes. RESULTS No significant interferences or carry-over were observed. Imprecisions, absolute relative biases, normalised matrix effects and recoveries were ≤15.0 %, ≤11.1 %, (94.7-104.1)% and (96.7-105.5)%, respectively. Non-linear measuring intervals were observed between (25-10,000) µg/L for total/plasma dialysate concentrations and linearity schemes (1.00-100) µg/L for buffer dialysate concentrations. CONCLUSIONS The UHPLC-MS/MS procedures developed could be used for research purposes and therapeutic drug monitoring of antiretrovirals in routine clinical practice.
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Affiliation(s)
- Raúl Rigo-Bonnin
- Department of Clinical Laboratory, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Laura García-Tejada
- Department of Clinical Laboratory, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Virgínia Mas-Bosch
- Department of Clinical Laboratory, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Arkaitz Imaz
- Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infection (STI) Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan Manuel Tiraboschi
- Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infection (STI) Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sofía Scévola
- Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infection (STI) Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Niubó
- Department of Microbiology, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Antonio Navarro-Alcaraz
- Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infection (STI) Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Microbial Genomics Group, IrsiCaixa-Institut de Recerca de la SIDA, Badalona, Spain
| | - Daniel Podzamczer
- Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infection (STI) Unit, Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; FLScience, Fight Infections Foundation, Badalona, Spain
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Podzamczer D, Imaz A, Lopez-Lirola A, Knobel H, Masiá M, Fanciulli C, Hernández C, Lagarde M, Gutierrez A, Curran A, Morano L, Montero-Alonso M, Troya J, Rigo R, Casadellà M, Navarro-Alcaraz A, Ardila F, Parera M, Bernal E, Echeverria P, Estrada V, Hidalgo-Tenorio C, Macias J, Prieto P, Portilla J, Valencia E, Vivancos MJ, Rivero A. Switching to bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) plus darunavir/cobicistat in heavily antiretroviral-experienced, virologically suppressed HIV-infected adults receiving complex regimens. J Antimicrob Chemother 2023; 78:2696-2701. [PMID: 37725999 DOI: 10.1093/jac/dkad285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVES To evaluate the efficacy and safety of the two-pill regimen bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) plus darunavir/cobicistat as a switching strategy in heavily treatment-experienced people living with HIV (PLWH). METHODS Multicentre, prospective, single-arm pilot clinical trial. Participants were virologically suppressed adults receiving a stable antiretroviral regimen of at least three pills from at least three drug families due to previous virological failures and/or toxicities with no documented resistance to integrase strand transfer inhibitors or darunavir (≥15 points, Stanford). Clinical and laboratory assessments were performed at 0, 4, 12, 24, 36 and 48 weeks. HIV-1 proviral DNA was amplified and sequenced by Illumina at baseline. Plasma bictegravir concentrations were determined in 22 patients using UHPLC-MS/MS. The primary study endpoint was viral load (VL)< 50 copies/mL at Week 48 (ITT). RESULTS We enrolled 63 participants (92% men) with median baseline CD4 count of 515 cells/mm3 (IQR: 334.5-734.5), 24 years on ART (IQR: 15.9-27.8). The median number of pills was 4 (range: 3-10). At baseline, proviral DNA was amplified in 39 participants: 33/39 had resistance mutations. Three participants discontinued owing to toxicity. At 48 weeks, 95% had VL < 50 copies/mL by ITT and 100% by PP analysis. A modest increase was observed in the bictegravir plasma concentration, and a significant decrease in estimated glomerular filtration rate was observed only at Week 4, probably related to interaction with renal transporters. CONCLUSIONS Our data suggest that BIC/FTC/TAF + darunavir/cobicistat is an effective, well-tolerated regimen that may improve convenience and, potentially, long-term success in stable heavily pre-treated PLWH.
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Affiliation(s)
| | - Arkaitz Imaz
- Infectious Diseases Department, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospitalet del Llobregat, Hospital Universitario de Bellvitge, Spain
| | - Ana Lopez-Lirola
- Infectious Diseases Department, Hospital universitario de Canarias, San Cristóbal de la Laguna, Spain
| | - Hernando Knobel
- Infectious Diseases Department, Hospital del Mar, Barcelona, Spain
| | - Mar Masiá
- Infectious Diseases Department, Hospital Universitario general de Elche, Elche, Spain
| | - Chiara Fanciulli
- Infectious Diseases Department, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina Hernández
- Infectious Diseases Department, Hospital Príncipe de Asturias, Alcalá de Henares, Spain
| | - María Lagarde
- Infectious Diseases Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Angela Gutierrez
- Infectious Diseases Department, Hospital Universitario de la Princesa, Madrid, Spain
| | - Adrià Curran
- Infectious Diseases Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Luis Morano
- Infectious Diseases Department, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Marta Montero-Alonso
- Infectious Diseases Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Jesús Troya
- Infectious Diseases Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Raúl Rigo
- Infectious Diseases Department, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospitalet del Llobregat, Hospital Universitario de Bellvitge, Spain
| | - María Casadellà
- Microbial Genomics Group, IrsiCaixa-Institut de Recerca de la SIDA, Badalona, Spain
| | | | - Fernando Ardila
- Infectious Diseases Department, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Hospitalet del Llobregat, Hospital Universitario de Bellvitge, Spain
| | - Mariona Parera
- Microbial Genomics Group, IrsiCaixa-Institut de Recerca de la SIDA, Badalona, Spain
| | - Enrique Bernal
- Infectious Diseases Department, Hospital Universitario Reina Sofía, Murcia, Spain
| | - Patricia Echeverria
- Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Vicente Estrada
- Infectious Diseases Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Carmen Hidalgo-Tenorio
- Infectious Diseases Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Juan Macias
- Instituto de Biomedicina de Sevilla, Departamento de Medicina, CIBERINFEC, Unidad de Enfermedades Infecciosas y Microbiología, IBiS/Hospital Universitario Virgen de Valme/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Paula Prieto
- Infectious Diseases Department, Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Joaquín Portilla
- Infectious Diseases Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Eulalia Valencia
- Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain
| | - María Jesús Vivancos
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Antonio Rivero
- Department of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Córdoba, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas Instituto de Salud Carlos III, Madrid, Spain
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Podzamczer D, Micán R, Tiraboschi J, Portilla J, Domingo P, Llibre JM, Ribera E, Vivancos MJ, Morano L, Masiá M, Gómez C, Fanjul F, Payeras A, Inciarte A, Estrada V, Rivero A, Castro Á, Bernal E, Vinuesa D, Knobel H, Troya J, Macías J, Montero M, Sanz J, Navarro-Alcaraz A, Caicedo A, Fernández G, Martínez E, Moreno S. Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Versus Dolutegravir/Abacavir/Lamivudine in Antiretroviral-Naive Adults (SYMTRI): A Multicenter Randomized Open-Label Study (PReEC/RIS-57). Open Forum Infect Dis 2021; 9:ofab595. [PMID: 35237700 PMCID: PMC8883591 DOI: 10.1093/ofid/ofab595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) is the reference for combination therapy based on protease inhibitors due to its efficacy, tolerability, and convenience. Head-to-head randomized comparisons between D/C/F/TAF and combination therapy based on integrase inhibitors in antiretroviral-naive patients are lacking. Methods Adult (>18 years old) human immunodeficiency virus-infected antiretroviral-naive patients (HLA-B∗5701 negative and hepatitis B virus negative), with viral load (VL) ≥500 c/mL, were centrally randomized to initiate D/C/F/TAF or dolutegravir/abacavir/lamivudine (DTG/3TC/ABC) after stratifying by VL and CD4 count. Clinical and analytical assessments were performed at weeks 0, 4, 12, 24, and 48. The primary endpoint was VL <50 c/mL at week 48 in the intention-to-treat (ITT)-exposed population (US Food and Drug Administration snapshot analysis, 10% noninferiority margin). Results Between September 2018 and 2019, 316 patients were randomized and 306 patients were included in the ITT-exposed analysis (151 D/C/F/TAF and 155 DTG/3TC/ABC). Almost all (94%) participants were male and their median age was 35 years. Forty percent had a baseline VL >100 000 copies/mL, and 13% had <200 CD4 cells/μL. Median weight was 73 kg and median body mass index was 24 kg/m2. At 48 weeks, 79% (D/C/F/TAF) versus 82% (DTG/3TC/ABC) had VL <50 c/mL (difference, −2.4%; 95% confidence interval [CI], −11.3 to 6.6). Eight percent versus four percent experienced virologic failure but no resistance-associated mutations emerged. Four percent versus six percent had drug discontinuation due to adverse events. In the per-protocol analysis, 94% versus 96% of patients had VL <50 c/mL (difference, −2%; 95% CI, −8.1 to 3.5). There were no differences in CD4 cell count or weight changes. Conclusions We could not demonstrate the noninferiority of D/C/F/TAF relative to DTG/ABC/3TC as initial antiretroviral therapy, although both regimens were similarly well tolerated.
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Affiliation(s)
- D Podzamczer
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - R Micán
- Hospital La Paz, Madrid, Spain
| | - J Tiraboschi
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - J Portilla
- Hospital General Universitario de Alicante, Alicante, Spain
| | - P Domingo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J M Llibre
- Hospital Germans Trias i Pujol, Barcelona, Spain
| | - E Ribera
- Hospital Universitario de la Vall d’Hebrón, Barcelona, Spain
| | - M J Vivancos
- Hospital Universitario Ramón y Cajal, Madrid, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - L Morano
- Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - M Masiá
- Hospital General Universitario de Elche, Elche, Spain
| | - C Gómez
- Hospital Universitario Virgen de la Victoria-IBIMA, Málaga, Spain
| | - F Fanjul
- Hospital Universitario Son Espases, Palma, Spain
| | - A Payeras
- Hospital Universitario Son Llàtzer, Palma, Spain
| | | | - V Estrada
- Hospital Clínico San Carlos-IdiSSC, Madrid, Spain
| | - A Rivero
- Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Á Castro
- Complejo Hospitalario Universitario, A Coruña, Spain
| | - E Bernal
- Hospital Universitario Reina Sofía, Murcia, Spain
| | - D Vinuesa
- Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - H Knobel
- Hospital del Mar, Barcelona, Spain
| | - J Troya
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J Macías
- Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - M Montero
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - J Sanz
- Hospital Universitario de La Princesa, Madrid, Spain
| | | | - A Caicedo
- RIS Red de Investigación en SIDA, Madrid, Spain
| | - G Fernández
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - S Moreno
- Hospital Universitario Ramón y Cajal, Madrid, Universidad de Alcalá, IRYCIS, Madrid, Spain
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Tiraboschi JM, Rojas J, Zetterberg H, Blennow K, Niubo J, Gostner J, Navarro-Alcaraz A, Piatti C, Fuchs D, Gisslén M, Rigo-Bonnin R, Martinez E, Podzamczer D. No Changes in Human Immunodeficiency Virus (HIV) Suppression and Inflammatory Markers in Cerebrospinal Fluid in Patients Randomly Switched to Dolutegravir Plus Lamivudine (Spanish HIV/AIDS Research Network, PreEC/RIS 62). J Infect Dis 2020; 223:1928-1933. [PMID: 33049035 DOI: 10.1093/infdis/jiaa645] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/07/2020] [Indexed: 11/14/2022] Open
Abstract
A major concern of human immunodeficiency virus (HIV) dual therapy is a potentially lower efficacy in viral reservoirs, especially in the central nervous system (CNS). We evaluated HIV RNA, neuronal injury, and inflammatory biomarkers and dolutegravir (DTG) exposure in cerebrospinal fluid (CSF) in patients switching to DTG plus lamivudine (3TC). All participants maintained viral suppression in plasma and CSF at week 48. We observed no increase in CSF markers of inflammation or neuronal injury. Median (interquartile range) total and unbound DTG in CSF were 7.3 (5.9-8.4) and 1.7 (1.2-1.9) ng/mL, respectively. DTG+3TC may maintain viral control without changes in inflammatory/injury markers within the CNS reservoir.
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Affiliation(s)
- Juan M Tiraboschi
- Bellvitge University Hospital. Bellvitge Biomedical Research Institute. University of Barcelona, Barcelona, Spain
| | - Jhon Rojas
- Infectious Diseases Service, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,UK Dementia Research Institute at UCL, London, United Kingdom.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jordi Niubo
- Bellvitge University Hospital. Bellvitge Biomedical Research Institute. University of Barcelona, Barcelona, Spain
| | | | - Antonio Navarro-Alcaraz
- Bellvitge University Hospital. Bellvitge Biomedical Research Institute. University of Barcelona, Barcelona, Spain
| | - Camila Piatti
- Bellvitge University Hospital. Bellvitge Biomedical Research Institute. University of Barcelona, Barcelona, Spain
| | | | - Magnus Gisslén
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Sahlgrenska University Hospital, Department of Infectious Diseases, Gothenburg, Sweden
| | - Raul Rigo-Bonnin
- Pharmacology Service, Bellvitge University Hospital, Barcelona, Spain
| | - Esteban Martinez
- Infectious Diseases Service, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Daniel Podzamczer
- Bellvitge University Hospital. Bellvitge Biomedical Research Institute. University of Barcelona, Barcelona, Spain
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Navarro-Alcaraz A, Tiraboschi J, Gómez C, Candas-Estébanez B, Saumoy M, Imaz A, Podzamczer D. Lack of benefit with omega-3 fatty acid supplementation in HIV patients: A randomized pilot study. HIV Res Clin Pract 2019; 20:99-105. [DOI: 10.1080/25787489.2019.1656426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Antonio Navarro-Alcaraz
- HIV and STD Unit, Infectious Disease Service, Bellvitge University Hospital, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Juan Tiraboschi
- HIV and STD Unit, Infectious Disease Service, Bellvitge University Hospital, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Carmen Gómez
- Rheumatology Service, Bellvitge University Hospital, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Beatriz Candas-Estébanez
- Clinical Laboratory, Bellvitge University Hospital, L’Hospitalet del Llobregat, Barcelona, Spain
| | - María Saumoy
- HIV and STD Unit, Infectious Disease Service, Bellvitge University Hospital, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Arkaitz Imaz
- HIV and STD Unit, Infectious Disease Service, Bellvitge University Hospital, L’Hospitalet del Llobregat, Barcelona, Spain
| | - Daniel Podzamczer
- HIV and STD Unit, Infectious Disease Service, Bellvitge University Hospital, L’Hospitalet del Llobregat, Barcelona, Spain
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Tiraboschi J, Navarro-Alcaraz A, Giralt D, Gomez-Vaquero C, Saumoy M, Imaz A, Podzamczer D. Changes in Body Fat Distribution in Antiretroviral-Naive HIV-Positive Individuals Initiating Current ART Regimens. J Clin Endocrinol Metab 2019; 104:900-905. [PMID: 30371793 DOI: 10.1210/jc.2018-01489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/23/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To describe the changes in body fat distribution (BFD) occurring over 60 months in a group of antiretroviral therapy (ART)-naive individuals starting different antiretroviral regimens. METHODS A prospective ongoing fat change assessment including clinical evaluation and dual X-ray absorptiometry scan is being conducted in all consecutive patients initiating ART from January 2008. Arm, leg, trunk, and total fat as well as fat mass ratio were determined. RESULTS A total of 146 patients were included (80% male, 40% MSM). Mean age was 44 years, HIV-1 RNA was 4.98 log10 copies/mL, and CD4 count was 254 cells/μL. The most common initial antiretroviral combination included non-nucleoside reverse transcription inhibitor (NNRTI) drugs followed by protease inhibitor (PI) and integrase strand transfer inhibitor (INSTI)-based regimens. At month 36, an increase was seen in the body mass index (BMI), total fat, trunk fat, and limb fat. The fat mass ratio (FMR) also showed a significant increase in both men and women (P = 0.001). In patients receiving NNRTI- or INSTI-based regimens (but not PIs), there was a marginal but statistically significant increase in the FMR (0.10 and 0.07, respectively; P = 0.01). Sixty-two subjects completed 60 months of follow-up. FMR showed a significant increase even in the PI group at this time point (P < 0.03). CONCLUSIONS We observed a significant increase in the fat and lean body mass in all compartments and treatment groups over 36 and 60 months. Clinically irrelevant differences were found in fat distribution regardless of the treatment group and baseline characteristics. The data suggest that current antiretroviral regimens have little impact on BFD during the first years of treatment.
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Affiliation(s)
- Juan Tiraboschi
- HIV Unit, Infectious Disease Service, Bellvitge University Hospital, Barcelona, Spain
| | | | - Dolors Giralt
- HIV Unit, Infectious Disease Service, Bellvitge University Hospital, Barcelona, Spain
| | | | - Maria Saumoy
- HIV Unit, Infectious Disease Service, Bellvitge University Hospital, Barcelona, Spain
| | - Arkaitz Imaz
- HIV Unit, Infectious Disease Service, Bellvitge University Hospital, Barcelona, Spain
| | - Daniel Podzamczer
- HIV Unit, Infectious Disease Service, Bellvitge University Hospital, Barcelona, Spain
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