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The incidence of lipoatrophy with different antiretroviral regimens is well studied, but rarely is this outcome a primary endpoint. In this open-label trial, 237 treatment-naive HIV-infected patients (>70% men) were randomized to receive 3TC + efavirenz + either abacavir or d4T. The primary endpoint was the proportion of subjects with clinician- and patient-assessed lipoatrophy at 96 weeks. The two groups had comparable baseline CD4 counts (median, 175 cells/mm3 in the abacavir arm and 201 cells/mm3 in the d4T arm) and viral loads (median, 4.96 and 4.92 log copies/mL).
Of the 165 patients who completed the study, 14% had lipoatrophy alone, 10% had lipoaccumulation alone, and 7% had mixed lipodystrophy. Approximately 5% of patients in the aba…