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HIV<\/jats:styled-content>\u2010infected patients with moderate\/severe lipoatrophy at one or more body sites despite long\u2010term thymidine NRTI<\/jats:styled-content>\u2010free therapy were randomized to continue their efavirenz (EFV<\/jats:styled-content>)\u2010based antiretroviral regimen or to switch from EFV<\/jats:styled-content> to lopinavir\/ritonavir (LPV<\/jats:styled-content>\/r). The primary endpoint was the absolute change in limb fat mass measured by dual X\u2010ray absorptiometry from baseline to 96\u00a0weeks. Changes in other body fat measurements, subjective perception of lipoatrophy, subcutaneous fat gene expression and plasma lipids were also assessed.<\/jats:p><\/jats:sec>Results<\/jats:title>Thirty\u2010three patients (73% men, median age 52\u00a0years) were recruited. At 96\u00a0weeks, absolute limb fat mass increased in the LPV<\/jats:styled-content>\/r arm vs<\/jats:italic>. the EFV<\/jats:styled-content> arm (estimated difference +1082.1\u00a0g; 95% CI<\/jats:styled-content> +63.7 to +2103.5; P<\/jats:italic>\u00a0=\u00a00.04); this difference remained significant after adjustment by gender, age, fat mass, body mass index and CD<\/jats:styled-content>4 cell count at baseline. Subjective lipoatrophy perception scores also improved in the LPV<\/jats:styled-content>\/r arm relative to the EFV<\/jats:styled-content> arm. Adipogenesis, glucose and lipid metabolism, and mitochondrial gene expression increased in the LPV<\/jats:styled-content>\/r arm compared with the EFV<\/jats:styled-content> arm at 96\u00a0weeks. HDL<\/jats:styled-content> cholesterol decreased in the LPV<\/jats:styled-content>\/r arm relative to the EFV<\/jats:styled-content> arm.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Switching from EFV<\/jats:styled-content> to LPV<\/jats:styled-content>\/r in HIV<\/jats:styled-content>\u2010infected patients with lipoatrophy may offer further limb fat gain beyond thymidine NRTI<\/jats:styled-content> discontinuation, although this strategy decreased plasma HDL<\/jats:styled-content> cholesterol and caused changes in subcutaneous fat gene expression that may be associated with increased insulin resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12314","type":"journal-article","created":{"date-parts":[[2015,9,10]],"date-time":"2015-09-10T15:33:33Z","timestamp":1441899213000},"page":"340-349","source":"Crossref","is-referenced-by-count":3,"title":["Improvement of lipoatrophy by switching from efavirenz to lopinavir\/ritonavir"],"prefix":"10.1111","volume":"17","author":[{"given":"J","family":"Rojas","sequence":"first","affiliation":[{"name":"Hospital Cl\u00ednic\u2010IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Lonca","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic\u2010IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Imaz","sequence":"additional","affiliation":[{"name":"Hospital Universitari de Bellvitge Universitat de Barcelona L'Hospitalet de Llobregat Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V","family":"Estrada","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos Universidad Complutense de Madrid Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V","family":"Asensi","sequence":"additional","affiliation":[{"name":"Hospital Universitario Central de Asturias Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Miralles","sequence":"additional","affiliation":[{"name":"Complexo Hospitalario Universitario de Vigo Vigo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Domingo","sequence":"additional","affiliation":[{"name":"Hospital de Sant Pau Universitat Aut\u00f2noma de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Montero","sequence":"additional","affiliation":[{"name":"Hospital Universitari i Polit\u00e8cnic La Fe Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"del Rio","sequence":"additional","affiliation":[{"name":"CETIR Grup M\u00e8dic Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Fontdevila","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic\u2010IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Perez","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic\u2010IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Cruceta","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic\u2010IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JM","family":"Gatell","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic\u2010IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Arnedo","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic\u2010IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic\u2010IDIBAPS Universitat de Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,9,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2010.10.019"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832b4377"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/589622"},{"key":"e_1_2_6_5_1","unstructured":"European AIDS Clinical Society (EACS).Treatment Guidelines. 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