A 48-Week Study of Fat Molecular Alterations in HIV Naive Patients Starting Tenofovir/Emtricitabine With Lopinavir/Ritonavir or Efavirenz

Abstract

Starting TDF/FTC plus EFV was associated with an increased expression of genes encoding for inflammatory cytokines in SAT in naive patients. Therapy with TDF/FTC plus LPV/r or EFV was associated with an increase in subcutaneous fat mass.

Differential Subcutaneous Adipose Tissue Gene Expression Patterns in a Randomized Clinical Trial of Efavirenz or Lopinavir-Ritonavir in Antiretroviral-Naive Patients

“…Moreover, gene expression studies of subcutaneous adipose tissue may help us to better understand the mechanisms behind body fat changes in HIV-infected patients who initiate ART. Antiretroviral-drug-induced gene expression changes have been detected in adipocytes, in vitro (15,16) and in vivo, in healthy volunteers (17) and in HIV-infected patients (18)(19)(20)(21). In this study, we aimed to compare the effects of efavirenz (EFV) and those of ritonavir-boosted lopinavir (LPV/r), combined with emtricitabine and tenofovir, on body fat changes to evaluate the in vivo influence of each regimen on human subcutaneous adipose tissue gene expression and, additionally, to assess whether these transcript changes may be correlated with fat changes.…”

Fat Matters: Understanding the Role of Adipose Tissue in Health in HIV Infection

“…Among ART-treated persons with lipodystrophy, mtDNA is depleted in both VAT and SAT, metabolism and adipogenesis markers are decreased in SAT, and less pro-inflammatory gene expression occurs in VAT, potentially protecting it from depletion [62]. Finally, SAT pro-inflammatory cytokines increase more with efavirenz (vs lopinavir-ritonavir) in combination with tenofovir and emtricitabine [59]. …”

Potential role of the melanocortin signaling system interference in the excess weight gain associated to some antiretroviral drugs in people living with HIV

“…The specific tissue pharmacodynamics of each INsTI will most likely be different and thus may cause different effects, if any, on different cell types of the depot. Invasive procedures, such as adipose tissue biopsies, would be instrumental for that purpose [19].…”