Evidence synthesis evaluating body weight gain among people treating HIV with antiretroviral therapy - a systematic literature review and network meta-analysis.
Body weight gain
Dolutegravir
HIV
Network meta-analysis
Prognostic factors
Systematic review
Tenofovir alafenamide
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
13
12
2021
revised:
03
04
2022
accepted:
05
04
2022
entrez:
16
6
2022
pubmed:
17
6
2022
medline:
17
6
2022
Statut:
epublish
Résumé
This systematic review aimed to compare body weight gain associated outcomes over time between dolutegravir (DTG)-based antiretroviral (ART) regimens to other ART regimens, to compare tenofovir alafenamide (TAF)-based regimens, and to evaluate the associated prognostic factors. Systematic searches of MEDLINE, Embase, and CENTRAL for RCTs and observational studies comparing ART regimens were conducted on 13 September 2021. Outcomes of interest included: change in body weight, body mass index (BMI), waist circumference; and risk of hyperglycaemia and diabetes. Network meta-analyses were conducted at 12, 24, 48, 96 and 144 weeks using two networks differentiated by 3rd agents and backbone agents. The review identified 113 publications reporting on 73 studies. DTG-based regimens led to statistically higher weight gains than efavirenz-based regimens at all time points (mean difference: 1·99 kg at 96 weeks; 95% credible interval: 0·85-3·09) and was higher over time than low-dose efavirenz-, elvitegravir-, and rilpivirine-based regimens. They were comparable to raltegravir-, bictegravir- and atazanavir-based regimens. For backbones, TAF led to higher weight gain relative to tenofovir disoproxil fumarate (TDF), abacavir, and zidovudine. Prognostic factor analysis showed both low CD4 cell count and high HIV RNA viral load at baseline were consistently associated with higher weight gain, while sex was an effect modifier to African origins. DTG-based regimens lead to larger average weight gains than some other ART regimens and TAF leads to larger average weight gains than all other backbone antiretrovirals. Further research is needed to better understand long-term outcomes and their relationship to other metabolic outcomes. The WHO Global HIV, Hepatitis and Sexually Transmitted Infections Programmes.
Sections du résumé
Background
UNASSIGNED
This systematic review aimed to compare body weight gain associated outcomes over time between dolutegravir (DTG)-based antiretroviral (ART) regimens to other ART regimens, to compare tenofovir alafenamide (TAF)-based regimens, and to evaluate the associated prognostic factors.
Methods
UNASSIGNED
Systematic searches of MEDLINE, Embase, and CENTRAL for RCTs and observational studies comparing ART regimens were conducted on 13 September 2021. Outcomes of interest included: change in body weight, body mass index (BMI), waist circumference; and risk of hyperglycaemia and diabetes. Network meta-analyses were conducted at 12, 24, 48, 96 and 144 weeks using two networks differentiated by 3rd agents and backbone agents.
Findings
UNASSIGNED
The review identified 113 publications reporting on 73 studies. DTG-based regimens led to statistically higher weight gains than efavirenz-based regimens at all time points (mean difference: 1·99 kg at 96 weeks; 95% credible interval: 0·85-3·09) and was higher over time than low-dose efavirenz-, elvitegravir-, and rilpivirine-based regimens. They were comparable to raltegravir-, bictegravir- and atazanavir-based regimens. For backbones, TAF led to higher weight gain relative to tenofovir disoproxil fumarate (TDF), abacavir, and zidovudine. Prognostic factor analysis showed both low CD4 cell count and high HIV RNA viral load at baseline were consistently associated with higher weight gain, while sex was an effect modifier to African origins.
Interpretation
UNASSIGNED
DTG-based regimens lead to larger average weight gains than some other ART regimens and TAF leads to larger average weight gains than all other backbone antiretrovirals. Further research is needed to better understand long-term outcomes and their relationship to other metabolic outcomes.
Funding
UNASSIGNED
The WHO Global HIV, Hepatitis and Sexually Transmitted Infections Programmes.
Identifiants
pubmed: 35706487
doi: 10.1016/j.eclinm.2022.101412
pii: S2589-5370(22)00142-0
pmc: PMC9112095
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101412Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
Steve Kanters, Eve Limbrick-Oldfield, and Kenneth Zhang are employees at RainCity Analytics. All other authors have nothing to declare.
Références
Front Endocrinol (Lausanne). 2018 Nov 27;9:705
pubmed: 30542325
N Engl J Med. 2015 Aug 27;373(9):795-807
pubmed: 26192873
HIV Med. 2016 Apr;17(4):255-68
pubmed: 26216031
J Clin Epidemiol. 2011 Dec;64(12):1294-302
pubmed: 21803546
N Engl J Med. 2019 Aug 29;381(9):827-840
pubmed: 31329379
JAMA. 2020 Oct 27;324(16):1651-1669
pubmed: 33052386
J Clin Epidemiol. 2011 Dec;64(12):1311-6
pubmed: 21802902
AIDS. 2018 Feb 20;32(4):451-459
pubmed: 29381559
Epidemiology. 2018 May;29(3):431-441
pubmed: 29394189
Stat Med. 2010 Mar 30;29(7-8):932-44
pubmed: 20213715
J Virus Erad. 2019 Jan 1;5(1):41-43
pubmed: 30800425
J Clin Epidemiol. 2011 Dec;64(12):1303-10
pubmed: 21802903
Antivir Ther. 2012;17(7):1281-9
pubmed: 22951353
Stat Med. 2013 Jul 30;32(17):2935-49
pubmed: 23440610
Curr Opin Infect Dis. 2020 Feb;33(1):10-19
pubmed: 31789693
J Acquir Immune Defic Syndr. 2016 Oct 1;73(2):228-36
pubmed: 27171741
N Engl J Med. 2012 Apr 5;366(14):1270-3
pubmed: 22475591
Curr HIV/AIDS Rep. 2020 Apr;17(2):138-150
pubmed: 32072466
BMJ. 2008 Apr 26;336(7650):924-6
pubmed: 18436948
J Acquir Immune Defic Syndr. 2021 Mar 1;86(3):339-343
pubmed: 33148997
J Clin Epidemiol. 1997 Jun;50(6):683-91
pubmed: 9250266
Arch Intern Med. 2005 May 23;165(10):1179-84
pubmed: 15911733
EClinicalMedicine. 2020 Oct 16;28:100573
pubmed: 33294805
Clin Infect Dis. 2020 Sep 12;71(6):1379-1389
pubmed: 31606734
J Clin Epidemiol. 2011 Dec;64(12):1283-93
pubmed: 21839614
BMJ. 2019 Aug 28;366:l4898
pubmed: 31462531
AIDS Res Hum Retroviruses. 2016 Jan;32(1):50-8
pubmed: 26352511
Open Forum Infect Dis. 2014 Jul 01;1(2):ofu040
pubmed: 25734114
N Engl J Med. 2019 Aug 29;381(9):803-815
pubmed: 31339677
Clin Infect Dis. 2015 Jun 15;60(12):1852-9
pubmed: 25761868
Lancet. 2013 Nov 2;382(9903):1525-33
pubmed: 24152939
J Clin Epidemiol. 2011 Dec;64(12):1277-82
pubmed: 21802904
PLoS One. 2010 Apr 09;5(4):e10106
pubmed: 20419086
J Clin Epidemiol. 2011 Apr;64(4):407-15
pubmed: 21247734