Improvement in Lipoatrophy Associated with Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus--Infected Patients Switched from Stavudine to Abacavir or Zidovudine: The Results of the TARHEEL Study

McComsey, Grace A.; Ward, Douglas J.; Hessenthaler, Siegrid M.; Sension, Michael G.; Shalit, Peter; Lonergan, J. Tyler; Fisher, Robin L.; Williams, Vanessa C.; Hernandez, Jaime E.
January 2004
Clinical Infectious Diseases;1/15/2004, Vol. 38 Issue 2, p263
Academic Journal
Stavudine use is a contributing factor for lipoatrophy, whereas use of abacavir or zidovudine is less likely to cause this complication. The TARHEEL study was a 48-week, open-label study that assessed changes in lipoatrophy after abacavir (86 patients [73%]) or zidovudine (32 patients [27%]), 300 mg twice daily, was substituted for stavudine for 118 human immunodeficiency virus (HIV)—infected patients (HIV type 1 RNA level, <400 copies/mL) with virological suppression who had developed lipoatrophy after ≥6 months of stavudine-based treatment. At week 48, full-body dual-energy x-ray absorptiometry demonstrated a median increase in arm fat of 35%, leg fat of 12%, and trunk fat of 18%, compared with the baseline level. These improvements coincided with fat gain in lipoatrophic areas that was documented by computerized tomography. Results of a ’body image’ questionnaire showed that a substantial percentage of patients reported some or a lot of fat gain in the arms (22%), legs (18%), buttocks (19%), and face (27%). HIV suppression was maintained over the study period. In conclusion, replacing stavudine with abacavir or zidovudine resulted in improvement in stavudine-induced lipoatrophy.


Related Articles

  • Stavudine vs. Zidovudine as antiretroviral therapy. Sharma, Ajay; Modi, Megha; Sharma, Archana; Marfatia, Y. S. // Indian Journal of Sexually Transmitted Diseases;2007, Vol. 28 Issue 1, p26 

    Stavudine (d4T) and zidovudine (AZT) belong to nucleoside reverse transcriptase inhibitor (NRTI) group of drugs and they are the core drugs with lamivudine (3TC) as the first-line therapy. d4T is reported to cause a number of long-term metabolic and morphologic adverse drug reactions (ADR). In...

  • In--Vitro Resistance to Zidovudine and Alpha--Interferon in HIV--1 Isolates from Patients: Correlations with Treatment Duration and Response. Edlin, Brian R.; St. Clair, Marty H.; Pitha, P.M.; Whaling, Susan M. // Annals of Internal Medicine;9/15/92, Vol. 117 Issue 6, p457 

    Presents a study that measured in-vitro antiviral drug susceptibilities of human immunodeficiency virus type 1 isolates recovered from patients treated with alpha-interferon or zidovudine and patients not treated with these drugs. Methodology; Results and discussion; Conclusion.

  • zidovudine.  // Davis's Drug Guide for Nurses, 9th edition;2005, p1103 

    Provides information on the antiretroviral agent zidovudine. Therapeutic effects; Pharmacokinetics; Adverse reactions; Dosage.

  • Antiretrovirals.  // Reactions Weekly;5/2/2009, Issue 1250, p9 

    The article describes the case of five patients with AIDS who acquired dermatological manifestation of immune reconstitution syndrome. The patients developed their respective conditions while undergoing antiretroviral therapy. Some of the drugs given to patients were efavirenz, prednisone,...

  • Indinavir, Nevirapine, Stavudine, and Lamivudine for Human Immunodeficiency Virus-Infected, Amprenavir-Experienced Subjects: AIDS Clinical Trials Group Protocol 373. Gulick, Roy M.; Smeaton, Laura M.; D'Aquila, Richard T.; Eron, Joseph J.; Currier, Judith S.; Gerber, John G.; Acosta, Edward; Sommadossi, Jean-Pierre; Tung, Roger; Snyder, Sally; Kuritzkes, Daniel R.; Murphy, Robert L. // Journal of Infectious Diseases;3/1/2001, Vol. 183 Issue 5, p715 

    Presents a study which determined the antiretroviral activity and safety of the HIV drug regimens indinavir, nevirapine, stavudine, and lamivudine given to amprenavir-experienced subjects. Methodology; Study population; Results of the study on the amprenavir, zidovudine, and lamivudine groups.

  • ZDV.  // Taber's Cyclopedic Medical Dictionary;2005, p2367 

    The article presents a definition for the term "ZDV," which refers to Zidovudine, an antiviral drug used in the treatment of HIV.

  • A Comparison between Abacavir and Efavirenz as the Third Drug Used in Combination with a Background Therapy Regimen of 2 Nucleoside Reverse-Transcriptase Inhibitors in Patients with Initially Suppressed Viral Loads. Cozzi-Lepri, Alessandro; De Luca, Andrea; Phillips, Andrew N.; Bongiovanni, Marco; Di Giambenedetto, Simona; Mena, Maurizio; Moioli, Maria Cristina; Arlotti, Massimo; Sighinolfi, Laura; Narciso, Pasquale; Lichtner, Miriam; Cauda, Roberto; d'Arminio Monforte, Antonella // Journal of Infectious Diseases;7/1/2006, Vol. 194 Issue 1, p20 

    Background. Our objective was to compare the rate of viral rebound and therapy failure in patients receiving abacavir or efavirenz as the third drug (in addition to 2 non-abacavir nucleosides) in combination antiretroviral therapy (cART) and to compare the rate of metabolic alteration associated...

  • Combination Therapy with Zidovudine and Dideoxycytidine in Patients with Advanced Human Immunodeficiency Virus Infection. Tze-Chiang Meng; Fischl, Margaret A.; Boota, Ahmad M.; Spector, Stephen A.; Bennett, Donnaie; Bassiakos, Yiannis; Shenghan Lai; Wright, Brian; Richman, Douglas D. // Annals of Internal Medicine;1/1/92, Vol. 116 Issue 1, p13 

    Evaluates the safety and effects of combination therapy with zidovudine and dideoxycytidine in patients with advanced HIV infection. Characteristics of the patients; Side effects of the combination therapy; Changes in the CD4 antigen.

  • Nelfinavir/nevirapine/zidovudine withdrawal.  // Reactions Weekly;5/1/2004, Issue 999, p12 

    Discuses research being done on the development of multiple organ failure in a woman patient receiving nelfinavir, nevirapine and zidovudine for HIV infection. Reference to a study by M. Crespo et al published in a January 2004 issue of the "European Journal of Clinical Microbiology and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics