Changes in body composition and mitochondrial DNA in HIV-1-infected patients switching to fixed-dose abacavir/lamivudine or tenofovir/emtricitabine: A substudy of the BICOMBO trial

Adrian Curran, Esteban Martinez, Daniel Podzamczer, Montserrat Lonca, Patricia Barragan, Manuel Crespo, Vicenç Falco, Sergio Vidal-Sicart, Arkaitz Imaz, Maria Martinez, Jose Maria Gatell, Esteban Ribera

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Abstract

Background: Fat distribution, bone mineral density (BMD) and mitochondrial DNA (mtDNA) may improve, in the long-term, after switching from nucleoside reverse transcriptase inhibitors (NRTIs) to fixed-dose abacavir (ABC)/ lamivudine (3TC) or tenofovir (TDF)/emtricitabine (FTC). Methods: This was a prospective, randomized, open-label, multicentre substudy of the BICOMBO trial in which virologically suppressed patients had their NRTIs switched to ABC/3TC or TDF/FTC. Whole-body dualenergy X-ray absorptiometry (DXA) was used to measure limb, trunk and total body fat and total BMD. Lumbar and hip DXA scans were used to measure lumbar and hip BMD. Fat mass ratio (FMR; % trunk fat/% leg fat by whole-body DXA) was used to assess fat distribution. mtDNA was measured in peripheral blood mononuclear cells (PBMCs). Parameters of interest were measured at baseline, 48 and 96 weeks, and were compared between treatment groups. Results: Of 56 patients included, 45 (20 ABC/3TC and 25 TDF/FTC) completed the substudy. After 96 weeks, ABC/3TC (+756 g, +12.1%) and TDF/FTC (+337 g, +7.6%) led to non-significantly different increases in limb fat (P=0.60). By contrast, trunk fat showed a significant increase (P=0.04) with ABC/3TC (+1,184 g, +10.6%) relative to TDF/FTC (-370 g, -4.2%). Median (IQR) FMR remained unchanged with ABC/3TC (-0.01 [-0.16-0.06]; P=0.23), but it decreased significantly with TDF/FTC (-0.13 [-0.30-0.00]; P=0.007). Total BMD and mtDNA significantly increased after 96 weeks, without differences between groups. Conclusions: Switching from NRTIs to either ABC/3TC or TDF/FTC led to similar increases in limb fat, BMD and PBMC mtDNA after 96 weeks. ©2012 International Medical Press.
Original languageEnglish
Pages (from-to)711-718
JournalAntiviral Therapy
Volume17
Issue number4
DOIs
Publication statusPublished - 5 Jun 2012

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    Curran, A., Martinez, E., Podzamczer, D., Lonca, M., Barragan, P., Crespo, M., Falco, V., Vidal-Sicart, S., Imaz, A., Martinez, M., Gatell, J. M., & Ribera, E. (2012). Changes in body composition and mitochondrial DNA in HIV-1-infected patients switching to fixed-dose abacavir/lamivudine or tenofovir/emtricitabine: A substudy of the BICOMBO trial. Antiviral Therapy, 17(4), 711-718. https://doi.org/10.3851/IMP2081