Comparison of Bone and Renal Effects In HIV-infected Adults Switching to Abacavir or Tenofovir Based Therapy in a Randomized Trial 英文参考文献.docVIP

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Comparison of Bone and Renal Effects In HIV-infected Adults Switching to Abacavir or Tenofovir Based Therapy in a Randomized Trial 英文参考文献.doc

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Comparison of Bone and Renal Effects In HIV-infected Adults Switching to Abacavir or Tenofovir Based Therapy in a Randomized Trial 英文参考文献

ComparisonofBoneandRenalEffectsInHIV-infected AdultsSwitchingtoAbacavirorTenofovirBasedTherapy inaRandomizedTrial ThomasA.Rasmussen1*,DannyJensen2,MartinTolstrup1,UllaS.Nielsen1,ErlandJ.Erlandsen3, HenrikBirn2,Lars?stergaard1,BenteL.Langdahl4,AlexL.Laursen1 1DepartmentofInfectiousDiseases,AarhusUniversityHospital,Aarhus,Denmark,2DepartmentofNephrology,AarhusUniversityHospitalandInstituteofBiomedicine, Aarhus University, Aarhus, Denmark, 3Department of Clinical Biochemistry, Viborg Regional Hospital, Viborg, Denmark, 4Department of Endocrinology and Internal Medicine,AarhusUniversityHospital,Aarhus,Denmark Abstract Introduction: Our objective was to compare the bone and renal effects among HIV-infected patients randomized to abacavirortenofovir-basedcombinationanti-retroviraltherapy. Methods:Inanopen-labelrandomizedtrial,HIV-infectedpatientswererandomizedtoswitchfromzidovudine/lamivudine (AZT/3TC)toabacavir/lamivudine(ABC/3TC)ortenofovir/emtricitabine(TDF/FTC).Wemeasuredbonemassdensity(BMD) and bone turnover biomarkers (osteocalcin, osteocalcin, procollagen type 1 N-terminal propeptide (P1NP), alkaline phosphatase, type I collagen cross-linked C-telopeptide (CTx), and osteoprotegerin). We assessed renal function by estimated creatinine clearance, plasma cystatin C, and urinary levels of creatinine, albumin, cystatin C, and neutrophil gelatinase-associatedlipocalin(NGAL).ThechangesfrombaselineinBMDandrenalandbonebiomarkerswerecompared acrossstudyarms. Results:Of40includedpatients,35completed48weeksofrandomizedtherapyandfollowup.BMDwasmeasuredin33, 26,and27patientsatbaseline,week24,andweek48,respectively.InTDF/FTC-treatedpatientsweobservedsignificant reductionsfrombaselineinhipandlumbarspineBMDatweek24(21.8%and22.5%)andweek48(22.1%and22.1%), whereasBMDwasstableinpatientsintheABC/3TCarm.Thechanges frombaselineinBMDweresignificantlydifferent betweenstudyarms.AllboneturnoverbiomarkersexceptosteoprotegerinincreasedintheTDF/FTCarmcomparedwith the ABC/3TC arm, but earl