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Published on 11 May 2007

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Close ART patient monitoring urged

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Close monitoring of patients on different antiretroviral therapy(ART) strategies is necessary due to differential effects on lipidmetabolism and overall increases in insulin and insulin resistance, astudy has concluded.

The investigation assessedmetabolic-parameter and body-composition changes among 422antiretroviral-naïve patients randomised to three ART regimens:protease inhibitor (PI; n=141); non-nucleoside reverse transcriptaseinhibitor (NNRTI; n=141); and PI + NNRTI (n=140).

At baselineand one-month (metabolic parameters only) and four-month follow-upintervals, fat-free mass (FFM) and total body fat were calculated,anthropometric measurements were performed and fasting metabolicparameters were obtained. Patients were followed up for a median offive years.

The investigators reported that:

• PI+ NNRTI resulted in greater increases in triglycerides and LDLcholesterol compared with the PI- and NNRTI-alone strategies(p<0.005), with no differences between the latter two strategies.

• HDL cholesterol increased more in the NNRTI- than the PI-only arm (p<0.005).

• Insulin and insulin resistance increased similarly in all three arms.

•Changes in total and regional body composition (loss of subcutaneoustissue area and gains in FFM, nonsubcutaneous tissue area, and visceraltissue area) were observed but did not differ by treatment group.

J Acquir Immune Defic Syndr 2007;44:506-17

 



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