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首页> 外文期刊>The Journal of Antimicrobial Chemotherapy >Switching to lopinavir/ritonavir with or without abacavir/lamivudine in lipoatrophic patients treated with zidovudine/abacavir/lamivudine.
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Switching to lopinavir/ritonavir with or without abacavir/lamivudine in lipoatrophic patients treated with zidovudine/abacavir/lamivudine.

机译：在接受齐多夫定/阿巴卡韦/拉米夫定治疗的脂肪萎缩患者中，改用含或不含阿巴卡韦/拉米夫定的洛匹那韦/利托那韦。

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Discontinuation of thymidine nucleoside reverse transcriptase inhibitors (tNRTIs) is the only proven strategy for improving lipoatrophy. It is unclear whether switching to NRTI-sparing or to non-thymidine NRTI-containing therapy has differential effects on body fat recovery.This was a 96 week, open-label, randomized study in suppressed patients with moderate/severe lipoatrophy and no prior virological failure while receiving a protease inhibitor and who had their triple NRTI regimen (zidovudine/lamivudine/abacavir) switched to lopinavir/ritonavir plus abacavir/lamivudine for a 1 month run-in period and then randomized to lopinavir/ritonavir plus abacavir/lamivudine versus lopinavir/ritonavir monotherapy. The KRETA trial is registered with ClinicalTrials.gov (number NCT00865007).Of 95 patients included, 88 were randomized to lopinavir/ritonavir plus abacavir/lamivudine (n?=?44) or lopinavir/ritonavir monotherapy (n?=?44). Median (IQR) baseline limb fat was 2.5 (1.6-3.7) kg in the lopinavir/ritonavir plus abacavir/lamivudine group and 2.5 (2.0-5.4) kg in the lopinavir/ritonavir monotherapy group. Six patients in the triple therapy group and 13 in the monotherapy group had discontinued study drugs by week 96. Although there were limb fat gains in each group at weeks 48/96 (+324/+358 g in lopinavir/ritonavir plus abacavir/lamivudine, P?=?0.09/0.07, versus +215/+416 g in the lopinavir/ritonavir monotherapy group, P?=?0.28/0.16), differences between groups were not significant [difference +109 g (95% CI -442, +660)/-57 g (95% CI -740, +625)].In lipoatrophic patients treated with zidovudine/lamivudine/abacavir, switching to lopinavir/ritonavir monotherapy had no additional benefit in limb fat recovery relative to switching to lopinavir/ritonavir with abacavir/lamivudine. These data suggest that non-thymidine nucleosides such as abacavir/lamivudine are not an obstacle to limb fat recovery.
机译：终止胸苷核苷逆转录酶抑制剂（tNRTIs）是改善脂肪萎缩的唯一有效方法。尚不清楚转用保留NRTI的疗法或不使用含NRTI的非胸苷疗法是否对人体脂肪恢复产生不同的影响。这是一项为期96周的开放标签随机研究，用于中度/重度脂肪萎缩且既往无病毒学抑制的患者接受蛋白酶抑制剂且三联NRTI方案（zidovudine / lamivudine / abacavir）失败的患者，在1个月的试用期内改用lopinavir / ritonavir加abacavir / lamivudine，然后随机分配至lopinavir / ritonavir加abacavir / lamivudine与lopinavir / ritonavir单一疗法。 KRETA试验已在ClinicalTrials.gov上注册（编号NCT00865007），其中包括95名患者，其中88名被随机分配至lopinavir / ritonavir加abacavir / lamivudine（n = 44）或lopinavir / ritonavir单药治疗（n = 44）。洛匹那韦/利托那韦加阿巴卡韦/拉米夫定组的中位（IQR）基线肢体脂肪为2.5（1.6-3.7）kg，洛匹那韦/利托那韦单药治疗组为2.5（2.0-5.4）kg。三联疗法组中有6例患者，单药疗法组中有13例在第96周时停止研究药物。尽管每组在48/96周时都有肢体脂肪增加（洛匹那韦/利托那韦+阿巴卡韦/拉米夫定+ 324 / + 358 g） ，P？=？0.09 / 0.07，而洛匹那韦/利托那韦单药治疗组为+ 215 / + 416 g，P？=？0.28 / 0.16），各组之间的差异不显着[差异+109 g（95％CI -442） ，+660）/-57 g（95％CI -740，+625）]。在接受齐多夫定/拉米夫定/阿巴卡韦治疗的脂肪萎缩患者中，与使用lopinavir相比，使用lopinavir / ritonavir单药治疗对肢体脂肪恢复没有额外的好处。 / ritonavir和abacavir / lamivudine。这些数据表明，非胸腺嘧啶核苷如阿巴卡韦/拉米夫定对肢体脂肪的恢复没有障碍。

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