Cournil Amandine, Coudray Mathilde, Kouanfack Charles, Essomba Claudine Ntsama, Tonfack Clément Auguste Djouatsa, Biwolé-Sida Magloire, Delaporte Eric, Bork Kirsten, Laurent Christian
Institut de Recherche pour le Développement, University Montpellier 1, Montpellier, France.
Antivir Ther. 2010;15(7):1039-43. doi: 10.3851/IMP1664.
This study assessed the effect of stavudine (d4T) 30 mg dosage on lipoatrophy in HIV-infected patients on antiretroviral treatment.
A total of 243 patients from Cameroon receiving d4T or zidovudine (AZT) in combination with lamivudine and efavirenz or nevirapine for >6 months were clinically assessed for moderate to severe ('strict' definition) and mild to severe ('large' definition) lipoatrophy. Prevalence of lipoatrophy was compared between 69 patients who had received exclusively d4T 30 mg (d4T(30)), 64 patients who had received both d4T 30 and 40 mg dosages since treatment initiation (d4T(30/40)) and 110 patients on AZT-related therapy.
Prevalence of lipoatrophy varied from 7% to 24%, according to the definition. After adjustment for gender, age, treatment duration and CD4(+) T-cell count, the risk of lipoatrophy in the d4T(30) group was lower than in the d4T(30/40) group (odds ratio [OR] 0.3, 95% confidence interval [CI] 0.1-0.8 with the large definition and OR 0.2, 95% CI 0.0-0.8 with the strict definition) and was comparable to that of the AZT group (OR 1.0, 95% CI 0.2-4.6 and OR 1.0, 95% CI 0.4-2.2 with the large and strict definitions, respectively). The risk was significantly higher in the d4T(30/40) group compared with the AZT group (OR 2.9, 95% CI 1.3-6.4 with the large definition and OR 5.5, 95% CI 1.3-23.5 with the strict definition).
The use of d4T at a lower dosage might increase safety with regard to its effect on lipoatrophy.
本研究评估了司他夫定（d4T）30毫克剂量对接受抗逆转录病毒治疗的HIV感染患者脂肪萎缩的影响。
对喀麦隆的243例接受d4T或齐多夫定（AZT）联合拉米夫定和依非韦伦或奈韦拉平治疗超过6个月的患者进行临床评估，以确定中度至重度（“严格”定义）和轻度至重度（“宽泛”定义）脂肪萎缩情况。比较了69例仅接受30毫克d4T治疗的患者（d4T(30)）、64例自治疗开始后接受过30毫克和40毫克d4T剂量治疗的患者（d4T(30/40)）以及110例接受AZT相关治疗的患者的脂肪萎缩患病率。
根据定义，脂肪萎缩患病率在7%至24%之间。在对性别、年龄、治疗持续时间和CD4(+) T细胞计数进行调整后，d4T(30)组脂肪萎缩的风险低于d4T(30/40)组（宽泛定义下优势比[OR]为0.3，95%置信区间[CI]为0.1 - 0.8；严格定义下OR为0.2，95% CI为0.0 - 0.8），且与AZT组相当（宽泛定义下OR为1.0，95% CI为0.2 -
