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Little is known about the metabolic side effects of integrase inhibitors or whether they can reverse the effects that other drug classes have on fat and bone. New data from a manufacturer-supported trial provide some clues.
Researchers randomized clinically stable, virologically suppressed patients to either continue their boosted protease inhibitor (PI)–based regimen or replace the boosted PI with raltegravir, leaving the other components of the regimen unchanged. Seventy-four of the patients in the trial were included in a metabolic substudy; their mean duration of HIV infection was 13 years, and mean duration of exposure to PIs was almost 3 years. Fat mass ratio and limb-fat measurements indicated that the patients were not affected by li…