• 1
    Palella FJ, Jr, Delaney KM, Moorman AC et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 1998; 38: 853860.
  • 2
    Chesney M. Adherence to HAART regimens. AIDS Patient Care STDS 2003; 17: 169177.
  • 3
    Duran S, Saves M, Spire B et al. Failure to maintain long-term adherence to highly active antiretroviral therapy: the role of lipodystrophy. AIDS 2001; 15: 24412444.
  • 4
    Grinspoon S, Carr A. Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med 2005; 352: 4862.
  • 5
    Carr A, Samaras K, Burton S et al. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS 1998; 12: F51F58.
  • 6
    Martinez E, Larrousse M, Podzamczer D, Gatell JM. Objective amount of limb fat in HIV-infected subjects with subjective diagnosis of lipoatrophy. HIV Med 2009; 10: 257261.
  • 7
    Podzamczer D, Ferrer E, Martinez E et al. How much fat loss is needed for lipoatrophy to become clinically evident? AIDS Res Hum Retroviruses 2009; 25: 563567.
  • 8
    Josse G, Gensanne D, Aquilina C et al. Human immunodeficiency virus atropy induces modification of subcutaneous adipose tissue architecture: in vivo visualization by high-resolution magnetic resonance imaging. Br J Dermatol 2009; 160: 741746.
  • 9
    Bacchetti P, Gripshover B, Grunfeld C et al. Fat distribution in men with HIV infection. J Acquir Immune Defic Syndr 2005; 40: 121131.
  • 10
    Mallon PW, Miller J, Cooper DA, Carr A. Prospective evaluation of the effects of antiretroviral therapy on body composition in HIV-1-infected men starting therapy. AIDS 2003; 17: 971979.
  • 11
    Tavassoli N, Bagheri H, Sommet A et al. Effects of discontinuing stavudine or protease inhibitor therapy on human immunodeficiency virus-related fat redistribution evaluated by dual-energy x-ray absorptiometry. Pharmacotherapy 2006; 26: 154161.
  • 12
    Gallant JE, DeJesus E, Arribas JR et al. Tenofovir DF, emtricitabine, and efavirenz vs. zidovudine, lamivudine, and efavirenz for HIV. N Engl J Med 2006; 354: 251260.
  • 13
    Martin A, Smith DE, Carr A et al. Reversibility of lipoatrophy in HIV-infected patients 2 years after switching from a thymidine analogue to abacavir: the MITOX Extension Study. AIDS 2004; 18: 10291036.
  • 14
    McComsey GA, Ward DJ, Hessenthaler SM et al. Improvement in lipoatrophy associated with highly active antiretroviral therapy in human immunodeficiency virus-infected patients switched from stavudine to abacavir or zidovudine: the results of the TARHEEL study. Clin Infect Dis 2004; 38: 263270.
  • 15
    European AIDS Clinical Society (EACS). Guidelines, Version 6.1, 2012. Available at (accessed 12 December 2012).
  • 16
    John M, McKinnon EJ, James IR et al. Randomized, controlled, 48-week study of switching stavudine and/or protease inhibitors to combivir/abacavir to prevent or reverse lipoatrophy in HIV-infected patients. J Acquir Immune Defic Syndr 2003; 33: 2933.
  • 17
    Mallal SA, John M, Moore CB, James IR, McKinnon EJ. Contribution of nucleoside analogue reverse transcriptase inhibitors to subcutaneous fat wasting in patients with HIV infection. AIDS 2000; 14: 13091316.
  • 18
    Podzamczer D, Ferrer E, Sanchez P et al. Less lipoatrophy and better lipid profile with abacavir as compared to stavudine: 96-week results of a randomized study. J Acquir Immune Defic Syndr 2007; 44: 139147.
  • 19
    Tsekes G, Chrysos G, Douskas G et al. Body composition changes in protease inhibitor-naive HIV-infected patients treated with two nucleoside reverse transcriptase inhibitors. HIV Med 2002; 3: 8590.
  • 20
    Spanish AIDS Society. Panel de expertos de Gesida y Plan Nacional sobre el Sida. Documento de consenso de Gesida/Plan Nacional sobre el Sida respecto al tratamiento antirretroviral en adultos infectados por el virus de la inmunodeficiencia humana. Actualización enero 2012. Available at (accessed 12 December 2012).
  • 21
    Arribas JR, Pozniak AL, Gallant JE et al. Tenofovir disoproxil fumarate, emtricitabine, and efavirenz compared with zidovudine/lamivudine and efavirenz in treatment-naive patients: 144-week analysis. J Acquir Immune Defic Syndr 2008; 47: 7478.
  • 22
    Knobel H, Alonso J, Casado JL et al. Validation of a simplified medication adherence questionnaire in a large cohort of HIV-infected patients: the GEEMA Study. AIDS 2002; 16: 605613.
  • 23
    Carr A, Workman C, Smith DE et al. Abacavir substitution for nucleoside analogs in patients with HIV lipoatrophy: a randomized trial. JAMA 2002; 288: 207215.
  • 24
    Moyle GJ, Baldwin C, Langroudi B, Mandalia S, Gazzard BG. A 48-week, randomized, open-label comparison of three abacavir-based substitution approaches in the management of dyslipidemia and peripheral lipoatrophy. J Acquir Immune Defic Syndr 2003; 33: 2228.
  • 25
    Moyle GJ, Sabin CA, Cartledge J et al. A randomized comparative trial of tenofovir DF or abacavir as replacement for a thymidine analogue in persons with lipoatrophy. AIDS 2006; 20: 20432050.
  • 26
    Ribera E, Paradiñeiro JC, Curran A et al. Improvements in subcutaneous fat, lipid profile, and parameters of mitochondrial toxicity in patients with peripheral lipoatrophy when stavudine is switched to tenofovir (LIPOTEST Study). HIV Clin Trials 2008; 9: 407417.
  • 27
    Fisher M, Moyle GJ, Shahmanesh M et al. A randomized comparative trial of continued zidovudine/lamivudine or replacement with tenofovir disoproxil fumarate/emtricitabine in efavirenz-treated HIV-1-infected individuals. J Acquir Immune Defic Syndr 2009; 51: 562568.
  • 28
    Martinez E, Arranz JA, Podzamczer D et al. A simplification trial switching from nucleoside reverse transcriptase inhibitors to once-daily fixed-dose abacavir/lamivudine or tenofovir/emtricitabine in HIV-1-infected patients with virological suppression. J Acquir Immune Defic Syndr 2009; 51: 290297.
  • 29
    DeJesus E, Ruane P, McDonald C et al. Impact of switching virologically suppressed, HIV-1-infected patients from twice-daily fixed-dose zidovudine/lamivudine to once-daily fixed-dose tenofovir disoproxil fumarate/emtricitabine. HIV Clin Trials 2008; 9: 103114.
  • 30
    DeJesus E, Young B, Morales-Ramirez JO et al. Simplification of antiretroviral therapy to a single-tablet regimen consisting of efavirenz, emtricitabine, and tenofovir disoproxil fumarate versus unmodified antiretroviral therapy in virologically suppressed HIV-1-infected patients. J Acquir Immune Defic Syndr 2009; 51: 163174.
  • 31
    Tungsiripat M, O'Riordan MA, Storer N et al. Subjective clinical lipoatrophy assessment correlates with DEXA-measured limb fat. HIV Clin Trials 2009; 10: 314319.
  • 32
    Benn P, Sauret-Jackson V, Cartledge J et al. Improvements in cheek volume in lipoatrophic individuals switching away from thymidine nucleoside reverse transcriptase inhibitors. HIV Med 2009; 10: 351355.
  • 33
    Yang Y, Yap M, Oo TN, Paton NI. Objective assessment of facial lipoatrophy changes in a cohort of HIV-infected patients taking combination antiretroviral therapy. HIV Clin Trials 2008; 9: 399406.