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Study Evaluating the Impact on Fat Distribution of Nucleoside Reverse Transcriptase Inhibitor (NRTI)-Sparing Regimens in Antiretroviral Experienced Patients With Lipoatrophy

This study has been terminated.
Information provided by:
French National Agency for Research on AIDS and Viral Hepatitis Identifier:
First received: July 21, 2005
Last updated: November 14, 2005
Last verified: November 2005

The aim of this trial is to evaluate the impact on fat distribution of switching to NRTI-sparing regimens in lipoatrophic antiretroviral experienced patients with complete viral suppression.

Maintenance of virological suppression and immunological factors are also assessed.

Condition Intervention Phase
HIV Infections HIV Lipodystrophy Syndrome Drug: non-nucleoside reverse transcriptase inhibitors Drug: nucleoside reverse transcriptase inhibitors Drug: protease inhibitors Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized Prospective Study Evaluating the Impact on Fat Distribution of NRTI-Sparing Regimens in Antiretroviral Experienced Patients With Lipoatrophy ANRS 108 NONUKE Study

Resource links provided by NLM:

Further study details as provided by French National Agency for Research on AIDS and Viral Hepatitis:

Primary Outcome Measures:
  • Evolution from inclusion to week 48 of the peripheral fat tissue measured on computed tomography (CT) scan by a volumetric fat centralized evaluation of the thighs

Secondary Outcome Measures:
  • Evolution of the viral load (VL) from inclusion to week 48 and proportion of patients with a VL over 400 copies/ml at week 48
  • Change in CD4 cell count between day 0 (D0) and week 48
  • Change in lipid profile and glucidic metabolism between D0 and week 48
  • Evolution of SAT/TAT and VAT/TAT between D0 and week 48

Estimated Enrollment: 100
Study Start Date: January 2001
Estimated Study Completion Date: June 2005
Detailed Description:
Limitations on achieving complete HIV eradication render it necessary to maintain highly active antiretroviral treatment over long periods, which may lead to the development of antiretroviral-associated toxicities. The current standard-of-care HAART regimens include a backbone of 2 nucleoside reverse transcriptase inhibitors (NRTIs). Many studies have demonstrated that NRTIs particularly thymidine analogue nucleosides are important contributors to the development of lipoatrophy. This antiretroviral family inhibits also the mitochondrial gamma-DNA polymerase, which leads to mitochondrial dysfunction and side effects such as peripheral neuropathy, pancreatitis and liver dysfunction.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Males and non-pregnant females
  • Confirmed laboratory diagnosis of HIV infection
  • Patients receiving a 2 or 3 NRTI-containing antiretroviral treatment for at least 3 months
  • Viral load below 400 copies/ml
  • Patients with a clinical peripheral lipoatrophy isolated or associated with a lipohypertrophy self reported by the patient and confirmed by physical examination

Exclusion Criteria:

  • Current antiretroviral therapy with 3 classes of antiretroviral therapy
  • Previous virologic failure with a non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI)
  • Intolerance to nevirapine and efavirenz
  • Acute opportunistic infection
  • Diabetes
  • Transaminase levels over 5 times above the upper normal limit
  • Hepatitis B virus (HBV) co-infection if the patient is receiving lamivudine therapy
  • Ongoing immunotherapy including interleukin-2 (IL-2) and interferon
  • Pregnancy or planned pregnancy
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Please refer to this study by its identifier: NCT00122655

Service des Maladies infectieuses et Tropicales Hopital Pitie Salpetriere
Paris, France, 75013
Sponsors and Collaborators
French National Agency for Research on AIDS and Viral Hepatitis
Principal Investigator: Marc Antoine Valantin, MD Service des Maladies Infectieuses Hopital Pitie-Salpetriere Paris
Study Chair: Dominique Costagliola INSERM U720
  More Information Identifier: NCT00122655     History of Changes
Other Study ID Numbers: ANRS108 NONUKE
Study First Received: July 21, 2005
Last Updated: November 14, 2005

Keywords provided by French National Agency for Research on AIDS and Viral Hepatitis:
HIV infections
HIV Lipodystrophy Syndrome

Additional relevant MeSH terms:
HIV Infections
HIV-Associated Lipodystrophy Syndrome
Lentivirus Infections
Retroviridae Infections
RNA Virus Infections
Virus Diseases
Sexually Transmitted Diseases, Viral
Sexually Transmitted Diseases
Immunologic Deficiency Syndromes
Immune System Diseases
Skin Diseases, Metabolic
Skin Diseases
Lipid Metabolism Disorders
Metabolic Diseases
Protease Inhibitors
HIV Protease Inhibitors
Reverse Transcriptase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-HIV Agents
Anti-Retroviral Agents
Antiviral Agents
Anti-Infective Agents
Nucleic Acid Synthesis Inhibitors processed this record on August 17, 2017