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Thymidine-analogue nucleoside reverse transcriptase inhibitors (NRTIs) are the biggest culprits when it comes to lipodystrophy induced by antiretroviral therapy. However, patients on various thymidine-sparing regimens can also develop the condition, with risks and patterns of illness that are quite unpredictable.
Seeking to clarify this murky area, researchers conducted a substudy within ACTG 5202, a clinical trial in which antiretroviral-naive HIV-infected adults were randomized to one of four thymidine-sparing regimens: abacavir/3TC or tenofovir/FTC, combined with either efavirenz or ritonavir-boosted atazanavir. A total of 269 individuals were evaluated, with computed tomography (CT) and dual-energy x-ray absorptiometry scans, for early c…