Thymidine analogue withdrawal for lipoatrophic patients on protease-sparing therapy improves lipoatrophy but compromises antiviral control: the PllLR extension study

Eighteen patients with HIV lipoatrophy, receiving quadruple reverse transcriptase-inhibitor therapy including stavudine or zidovudine, were randomly assigned to continue current therapy or stop stavudine/zidovudine. After 24 weeks more limb fat had recovered in the stop than in the continue group; however, five of the stop subjects experienced virological failure. The withdrawal of thymidine analogues from a protease inhibitor-sparing regimen can improve peripheral fat, but compromises virological control.