HIV Digest	HIV Digest Archive

Abacavir (ABC, Ziagen) or tenofovir (TDF, Viread): Which is a better bet when attempting to help alleviate the lipoatrophy experienced by patients who are taking stavudine (d4T, Zerit) or zidovudine (AZT, Retrovir)? The latest RAVE study results show that, although both abacavir and tenofovir can modestly improve lipoatrophy after a switch, tenofovir is better tolerated than abacavir, and also has a more favorable impact on lipid levels-- particularly when patients switch to it from stavudine.

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RAVE is a randomized, open-label, 48-week British study of 105 patients who were taking a thymidine analog (stavudine or zidovudine) along with another nucleoside analog and either a protease inhibitor or non-nucleoside agent. These patients were on stable antiretroviral therapy for more than 24 weeks and had a viral load below 50 copies/mL, but were experiencing moderate or severe lipoatrophy. After enrollment, all trial participants were randomized to change the thymidine analog to either tenofovir (n = 52) or abacavir (n = 53). (All participants were naive to both tenofovir and abacavir.)

Graeme Moyle presented 48-week data from this study at the 12th Conference on Retroviruses and Opportunistic Infections (CROI) this past February. Those results suggested that switching from a thymidine analog to tenofovir or abacavir resulted in significant improvements in limb fat, and noted that tenofovir led to fewer treatment discontinuations, and somewhat greater improvements in lipid profiles, than abacavir. The CROI results were not stratified by baseline thymidine analog, however; this presentation rectifies that omission, and updates the data presented at that conference.

Editor's Note: from theBodyPro.com