Progression of Lipodystrophy (LD) with Continued Thymidine Analogue Usage: Long-Term Follow-Up from a Randomized Clinical Trial (The PIILR Study)

Martin, Allison; Smith, Don; Carr, Andrew; Hoy, Jennifer; Chuah, John; Mallal, S.; Law, Matthew; Clements, Mark; Cooper, David A.

doi:10.1310/0gu7-6x27-mmhe-5ale

Cited by 13 publications

(5 citation statements)

References 28 publications

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“…A higher body mass index was associated with development of lipodystrophy during treatment for those on HAART. We also observed that prolonged use of a stavudine containing regimen increases the risk for lipodystrophy in agreement other reports [28,39].…”

Section: Discussionsupporting

confidence: 92%

Evaluation of the Prevalence, Progression and Severity of Common Adverse Reactions (Lipodystrophy, CNS, Peripheral Neuropathy, and Hypersensitivity Reactions) Associated with Anti-Retroviral Therapy (ART)and Anti-Tuberculosis Treatment in Outpatients in Zimbabwe

Nemaura¹,

Dhoro²,

Nhachi³

et al. 2013

J AIDS Clinic Res

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High mortality rates due to HIV and AIDS declined in resource rich countries with the discovery and access to anti-retroviral drugs (ARVs), starting with zidovudine in 1985 [5]. Through the Global Fund and concerted efforts of nongovernmental organisations, access to ARVs steadily increased in Sub-Saharan Africa. In addition, the Zimbabwean government initiated the AIDS Levy for all workers in 1999 as a national response to the HIV/AIDS pandemic. The AIDS Levy is a percentage of taxable income (3%) taken from every Zimbabwean employee's salary per month and deposited into the National AIDS Council (NAC) account for use in programs to combat HIV/AIDS in Zimbabwe [6]. By 2008, over 1 million people were infected with HIV and 500 000 required ART, but only a modest 100 000 currently have access to these life-saving drugs [7]. Given the recent evidence that ART not only reduces mortality rates but also reduces transmission rates [8], ART holds the promise to halting the spiral spread of the HIV pandemic. The access to ARVs has not been without difficulties. Earlier use of monotherapy was associated with the emergence of drug resistant variants of HIV [9]. Research in the 1990s led to the discovery of the more effective highly active anti-retroviral therapy (HAART) [10,11]. The use of ARVs was and continues to be associated with moderate, severe and sometimes life threatening adverse drug reactions. For many patients there is a shift from limited access to ARVs to issues of safety and efficacy in their use. As the use of ARVs was accessed by many patients across the world and used for long

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Section: Discussionsupporting

confidence: 92%

Evaluation of the Prevalence, Progression and Severity of Common Adverse Reactions (Lipodystrophy, CNS, Peripheral Neuropathy, and Hypersensitivity Reactions) Associated with Anti-Retroviral Therapy (ART)and Anti-Tuberculosis Treatment in Outpatients in Zimbabwe

Nemaura¹,

Dhoro²,

Nhachi³

et al. 2013

J AIDS Clinic Res

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“…A follow-up study of the same patients after 120 weeks found that body composition and metabolic features of lipodystrophy did not improve over time in patients continuing to receive protease inhibitor-sparing therapy. 15 In our study, long-term protease inhibitor discontinuation of 35.2 months (2.9 yrs) did not significantly affect the body composition profile of group 2 patients.…”

Section: Discussioncontrasting

confidence: 38%

“…14 In 120 weeks of follow-up of the same patients, no improvement in body composition or metabolic features of lipodystrophy was observed in patients continuing to receive predominantly protease inhibitor-sparing therapy. 15 In addition, lipodystrophy was worsened by continued stavudine therapy.…”

mentioning

confidence: 99%

Effects of Discontinuing Stavudine or Protease Inhibitor Therapy on Human Immunodeficiency Virus–Related Fat Redistribution Evaluated by Dual-Energy X-Ray Absorptiometry

Tavassoli¹,

Bagheri²,

Sommet³

et al. 2006

Pharmacotherapy

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“…Studies indicate that mortality rates associated with HIV infection have decreased with the use of antiretroviral therapy (ART) and HIV has emerged as a chronic disease (Bhatia et al, 2012;Kohli et al, 2006;Welsh et al, 2019). Enhanced survival rates with ART and subsequent aging, along with lifestyle choices (e.g., at-risk alcohol use) and living in an obesogenic environment, may increase the risk of metabolic comorbidities among PLWH (Bhatia et al, 2012;Bray, 2004;Bray & Popkin, 1999;Burgess et al, 2015;Carr, 2003;Falutz, 2011;Kohli et al, 2006;Martin et al, 2004;Wand et al, 2007;Willig & Overton, 2016;Worm et al, 2010). The development of insulin resistance (IR), which increases the risk for type 2 diabetes (T2D), is one of the most prevalent metabolic comorbidities in PLWH (Brener et al, 2016;Gutierrez & Balasubramanyam, 2012;Hadigan et al, 2000;Lombo et al, 2015;Muyanja et al, 2016;Willig & Overton, 2016;Zigman et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Alcohol use and dysglycemia among people living with human immunodeficiency virus (HIV) in the Alcohol & Metabolic Comorbidities in PLWH: Evidence Driven Interventions (ALIVE‐Ex) study

Primeaux

Simon

Ferguson

et al. 2021

Alcoholism Clin & Exp Res

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Background: At-risk alcohol use is a common and costly form of substance misuse that is highly prevalent among people living with HIV (PLWH). The goal of the current analysis was to test the hypothesis that PLWH with at-risk alcohol use are more likely to meet the clinical criteria for prediabetes/diabetes than PLWH with low-risk alcohol use. Methods: A cross-sectional analysis was performed on measures of alcohol and glycemic control in adult PLWH (n = 105) enrolled in a prospective, interventional study (the ALIVE-Ex Study (NCT03299205)) that investigated the effects of aerobic exercise on metabolic dysregulation in PLWH with at-risk alcohol use. The Alcohol Use Disorders Identification Test (AUDIT), Timeline Followback, and phosphatidylethanol (PEth) level were used to measure alcohol use. Participants were stratified into lowrisk (AUDIT score < 5) and at-risk alcohol use (AUDIT score ≥ 5). All participants underwent an oral glucose tolerance test and measures of glycemic control− the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Matsuda Index − were correlated with alcohol measures and compared by AUDIT score group using mixed-effects linear and logistic regression models, adjusting for age, sex, race, body mass index (BMI), and viral load. Results:In response to the glucose challenge, participants with at-risk alcohol use (n = 46) had higher glucose levels and were five times more likely to meet criteria for prediabetes/diabetes (OR: 5.3 (1.8, 15.9)) than participants with an AUDIT score < 5.Two-hour glucose values were positively associated with AUDIT score and PEth level and a higher percentage of PLWH with at-risk alcohol use had glucose values ≥140 mg/dl than those with low-risk alcohol use (34.8% vs. 10.2%, respectively). Conclusion:In this cohort of PLWH, at-risk alcohol use increased the likelihood of meeting the clinical criteria for prediabetes/diabetes (2-h glucose level ≥140 mg/dl).Established determinants of metabolic dysfunction (e.g., BMI, waist-hip ratio) were

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Progression of Lipodystrophy (LD) with Continued Thymidine Analogue Usage: Long-Term Follow-Up from a Randomized Clinical Trial (The PIILR Study)

Cited by 13 publications

References 28 publications

Evaluation of the Prevalence, Progression and Severity of Common Adverse Reactions (Lipodystrophy, CNS, Peripheral Neuropathy, and Hypersensitivity Reactions) Associated with Anti-Retroviral Therapy (ART)and Anti-Tuberculosis Treatment in Outpatients in Zimbabwe

Evaluation of the Prevalence, Progression and Severity of Common Adverse Reactions (Lipodystrophy, CNS, Peripheral Neuropathy, and Hypersensitivity Reactions) Associated with Anti-Retroviral Therapy (ART)and Anti-Tuberculosis Treatment in Outpatients in Zimbabwe

Effects of Discontinuing Stavudine or Protease Inhibitor Therapy on Human Immunodeficiency Virus–Related Fat Redistribution Evaluated by Dual-Energy X-Ray Absorptiometry

Alcohol use and dysglycemia among people living with human immunodeficiency virus (HIV) in the Alcohol & Metabolic Comorbidities in PLWH: Evidence Driven Interventions (ALIVE‐Ex) study

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