Follow-up data from 46 patients studied for a median of 104 weeks showed a median gain compared with baseline of 782 g of limb fat among the nonnucleoside patients and a median 900-g loss among patients receiving nucleosides.
Even though the median 13% gain in limb fat over 2 years represents a “relatively modest” increase, Dr. Tebas maintained that a switch to a nucleoside-sparing regimen is a valid therapeutic option for HIV patients with lipoatrophy. He warned, however, that the advantages of fat restoration must be weighed against the “inferior virologic potency” of nucleoside-sparing regimens.
Considering the poorly reversible nature of lipoatrophy as well as the fact that ART-induced changes in body-fat distribution can jeopardize the sustained effectiveness of and adherence to treatment, further research into the differences between specific antiretroviral agents within and between drug classes “is imperative,” said plenary speaker Peter Reiss, M.D., of the Academic Medical Center in Amsterdam.
Additionally, insights gleaned from such research “must be allowed to benefit patients and HIV treatment programs worldwide,” Dr. Reiss concluded.