SWITCHING TO A PROTEASE INHIBITOR-CONTAINING, NUCLEOSIDE-SPARING REGIMEN

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 背景：四肢皮下脂肪减少仍然是长期抗逆转录病毒疗法最令人不安的副作用之一。核苷类似物和蛋白酶抑制剂(PI)与这一并发症的发生有关。方法：我们评估了保留核苷和保留PI方案对62名未被选为脂肪萎缩患者的脂肪分布、骨密度和代谢参数的影响，这些受试者患有晚期HIV(最低的CD4计数或=200细胞/mm或HIV RNA水平或或=80,000拷贝/毫升)，且HIV病毒载量未被检测到。参与者被随机分组，将他们最初成功的抗逆转录病毒方案改为开放标记的洛匹那韦/利托那韦(LPV/r)，剂量为533/133毫克，每天两次，以及依法韦仑(EFV)，剂量为600 mg/d(核苷备用臂)，与EFV和2个核苷类似物(PI备用臂)进行比较。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. BACKGROUND: Subcutaneous limb fat loss continues to be one the most troubling side effects of long-term antiretroviral regimens. Nucleoside analogues and protease inhibitors (PIs) have been linked to the development of this complication. METHODS: We evaluated the effects of nucleoside-sparing and PI-sparing regimens on fat distribution, bone mineral density, and metabolic parameters in 62 subjects, who were not selected for lipoatrophy, with advanced HIV (nadir CD4 count <or=200 cells/mm or HIV RNA level >or=80,000 copies/mL) and an undetectable HIV viral load. Participants were randomized to switch their initial successful antiretroviral regimen to open-label lopinavir/ritonavir (LPV/r) at a dose of 533/133 mg twice a day and efavirenz (EFV) at a dose of 600 mg/d (the nucleoside-sparing arm) versus EFV and 2 nucleoside analogues (the PI-sparing arm).