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Abstract
EFFECT OF NUCLEOSIDE (NRTI) INTENSIFICATION ON PREVALENCE OF MORPHOLOGIC ABNORMALITIES (MOAS) AT YEAR 4 OF RITONAVIR (RTV) PLUS SAQUINAVIR (SQV) THERAPY IN AN HIV -INFECTED COHORT
COHEN C, RYAN J, JIANG P, CAMERON D, MELLORS J, KAKUDA T, JAPOUR A
Objectives: An ongoing RTV/SQV study with and without NRTI intensification allows partitioning the effect of NRTI therapy from PI therapy on the prevalence and risk factors of MoAs.
Methods: Standardized questionnaire and directed physical exam administered at Year 3 and Year 4. Potential risk factors evaluated using logistic regression models included NRTI intensification, duration of prior RTIs, baseline HIV RNA, baseline CD4+ cell count, lipid measurements, age, and gender.
Results: 35/90(39%) subjects remaining on study intensified with NRTI(s) prior to Year 3 with 46% and 94% on d4T and 3TC containing regimens, respectively. Prevalence of most common MoAs at Year 4 for NRTI-intensified vs. NRTI-sparing regimens was: buttock wasting (11/35 [31%] vs. 2/49 [4%], p<0.001) and thinning of cheeks (9/35 [26%] vs. 1/49 [4%], p<0.001), respectively. Using logistic regression models, risk factors for buttock wasting included NRTI intensification (odds ratio (OR) 10.1; 95% CI 2.08–49.3) and age (each 10-year increase; OR 2.4; 95% CI 1.07–5.18). NRTI intensification (OR 15.7; 95% CI 1.88–130.46) and age (OR 2.57; 95% CI 1.07-6.18) were also statistically significant risk factors for thinning of cheeks. Subjects completing 2 questionnaires 6 months apart reported MoA increases as follows: NRTI-intensified subjects (n = 33): buttock wasting (21.2 to 33.3%), waist size increase (3% to 12.1%), and thinning of cheeks (21.2% to 27.3%) and for NRTI-sparing subjects (n = 48): buttock wasting (4.2 to 8.3%). Self-reported, exam-confirmed presence of at least three MoAs at Year 4 for NRTI-intensified vs. NRTI-sparing regimens was 10/35(29%) vs. 0/49 (0%), respectively p<0.001.
Conclusions: In this study, NRTI intensification and older age were associated with an increased risk of morphologic abnormalities. Morphologic abnormalities were more frequent in subjects on an NRTI-intensified regimen with a greater number of abnormalities increasing with time.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
93
Suggested Citation
"COHENC, et al.
EFFECT OF NUCLEOSIDE (NRTI) INTENSIFICATION ON PREVALENCE OF MORPHOLOGIC ABNORMALITIES (MOAS) AT YEAR 4 OF RITONAVIR (RTV) PLUS SAQUINAVIR (SQV) THERAPY IN AN HIV -INFECTED COHORT.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
93"
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