A substudy of TMC114FD2HTX4004 that will perform glucose tolerance testing, adipose testing and MRI scan at baseline, 12 and 24 weeks post switch of ART medications.
Synopsis Full study title: Assessing the impact of integrase strand transfer inhibitors (INSTI) to protease inhibitor (PI) switch on insulin sensitivity and fat metabolism (ADIPOSITY): a sub-study of DEFINE Endpoints and objectives: The following endpoints will be determined 12 and 24 weeks after switch from an INSTI-based antiretroviral therapy (ART) regimen to a PI-based regimen: Primary endpoint: Change in insulin sensitivity (SI) at 12 weeks assessed by using a 3-hour frequently sampled oral glucose tolerance testing (fsOGTT). Secondary endpoints: 1) Change in insulin sensitivity (SI) at 24 weeks assessed by using a 3-hour frequently sampled oral glucose tolerance testing (fsOGTT); 2) Change in insulin secretion during the fsOGTT assessed by using C-peptide deconvolution; 3) Change in intrahepatic triglyceride (IHTG) content measured by magnetic resonance imaging (MRI); 4) Change in adipocyte size by the osmium tetroxide fixation technique; and 5) Change in expression of genes associated with adipose tissue development, lipogenesis, inflammation and endocrine function by RNA sequencing. Hypothesis: Insulin sensitivity will improve following switch from INSTIs to PIs
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
8
Frequently sampled glucose tolerance testing
abdominal subcutaneous adipose tissue biopsy
MRI scan to assess intrahepatic triglyceride content
Washington University School of Medicine
St Louis, Missouri, United States
Insulin Sensitivity measured by homeostatic model assessment for insulin resistance {HOMA_IR}
Change in insulin sensitivity (SI) at 12 weeks assessed by using a 3-hour frequently sampled oral glucose tolerance testing (fsOGTT).to calculate HOMA\_IR
Time frame: 12 weeks
Intrahepatic triglyceride (IHTG) content measure by magnetic resonance
Change in intrahepatic triglyceride (IHTG) content measured by magnetic resonance imaging (MRI
Time frame: 12 weeks
Intrahepatic triglyceride (IHTG) content measure by magnetic resonance
Change in intrahepatic triglyceride (IHTG) content measured by magnetic resonance imaging (MRI
Time frame: 24 weeks
Adipocyte size measured by osmium tetroxide fixation technique
Change in adipocyte size by the osmium tetroxide fixation technique
Time frame: 12 weeks
Adipocyte size measured by osmium tetroxide fixation technique
Change in adipocyte size by the osmium tetroxide fixation technique
Time frame: 24 weeks
Adipocyte gene expression correlated with adipose tissue development
Change in expression of adipose tissue genes correlated with adipose tissue development, lipogenesis, inflammation and endocrine function measured by RNA sequencing
Time frame: 12 weeks
Adipocyte gene expression correlated with adipose tissue development
Change in expression of adipose tissue genes correlated with adipose tissue development, lipogenesis, inflammation and endocrine function measured by RNA sequencing
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Time frame: 24 weeks
Insulin Sensitivity measured by homeostatic model assessment for insulin resistance {HOMA_IR}
Change in insulin sensitivity (SI) at 12 weeks assessed by using a 3-hour frequently sampled oral glucose tolerance testing (fsOGTT).to calculate HOMA\_IR
Time frame: 24 weeks