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Abstract
Long-term changes in body composition among HIV-infected antiretroviral naïve persons randomized to PI vs. NNRTI vs. PI + NNRTI-based antiretroviral regimens: results of the CPCRA 061 metabolic study
C.L. Gibert1, J.C. Shlay2, G. Bartsch3, G. Peng3, J. Wang4, F. Visnergarwala5, S. Raghavan6, Y. Xiang3, M. Farrough7, H.E. Perry8, C. Grunfeld9, W.M. El-Sadr6, for the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA)
Background: Information on long-term changes in body composition (BC) following initiation of different antiretroviral treatment (ART) strategies is limited.
Methods: We compared changes in BC in 422 patients randomized to 1 of 3 treatment strategies: PI (N=141), NNRTI (N=141), or PI+NNRTI (N=140) containing regimens [with NRTI(s)]. At baseline and 4-month intervals, fat-free mass (FFM) and total body fat (TBF) were measured using bioelectric impedance analysis. Subcutaneous tissue areas (STA) and non-STAs (NSTA) of midarm and midthigh, and STA and visceral tissue area (VTA) of waist were calculated from anthropometric measurements. Rates of change (unit/month) and mean change (unit) were compared by ART strategy.
Results: Median age was 38 years; 22% were women; 60% African American, and 10% Latino/a. Median follow-up was 5 years. Rates of change (i.e., slopes) after first follow-up visit were (*p-value < 0.05):
| | FFM
(kg/mo) | TBF
(kg/mo)
| Midarm
STA
(cm2/mo)
| Midarm
NSTA
(cm2/mo) | PI
| 0.03*
| 0.01
| -0.12*
| 0.11*
| | NNRTI | 0.02* | -0.02 | -0.13* | 0.05* | | PI+NNRTI | 0.02*
| 0.00
| -0.14*
| 0.08* | | | Midthigh
STA
(cm2/mo)
| Midarm
NSTA
(cm2/mo)
| Waist
STA
(cm2/mo)
| Waist
VTA
(cm2/mo)
| | PI | -0.15* | 0.06 | -0.17 | 0.73* | | NNRTI | -0.23* | -0.20* | -0.39* | 0.58* | | PI+NNRTI | -0.25* | -0.09 | -0.27* | 0.72* |
Neither rates of change nor mean change varied by strategy group.For all strategies, significant mean increases were observed in FFM and TBF, and in NSTA of midarm, midthigh, and waist VTA. The waist STA significantly increased in PI and PI+NNRTI strategies only.
Conclusions: In this prospective trial, changes in total and regional body fat did not differ by ART strategy, with losses demonstrated in STAs and gains in FFM, NSTAs, and VTA. In contradistinction to other studies, there was no significant difference by planned ART.
AIDS 2006 - XVI International AIDS Conference
Abstract no.
WEPE0143
Suggested Citation
"C.L.Gibert, et al.
Long-term changes in body composition among HIV-infected antiretroviral naïve persons randomized to PI vs. NNRTI vs. PI + NNRTI-based antiretroviral regimens: results of the CPCRA 061 metabolic study.
:
AIDS 2006 - XVI International AIDS Conference:
Abstract no.
WEPE0143"
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