Weight Gain Among Treatment-Naïve Persons With HIV Receiving Dolutegravir in Kenya.
Humans
Female
Male
HIV Infections
/ drug therapy
Thinness
/ drug therapy
Kenya
Heterocyclic Compounds, 3-Ring
/ therapeutic use
Oxazines
/ therapeutic use
Pyridones
/ therapeutic use
Reverse Transcriptase Inhibitors
/ therapeutic use
Weight Gain
Tuberculosis
/ drug therapy
HIV Integrase Inhibitors
/ therapeutic use
Journal
Journal of acquired immune deficiency syndromes (1999)
ISSN: 1944-7884
Titre abrégé: J Acquir Immune Defic Syndr
Pays: United States
ID NLM: 100892005
Informations de publication
Date de publication:
15 12 2022
15 12 2022
Historique:
received:
24
05
2022
accepted:
16
08
2022
pmc-release:
15
12
2023
pubmed:
21
9
2022
medline:
15
11
2022
entrez:
20
9
2022
Statut:
ppublish
Résumé
Several recent studies have linked integrase strand transfer inhibitors (INSTI) with increased weight gain. The effects of sex on weight gain with dolutegravir (DTG)-based antiretroviral therapy (ART) among treatment-naïve participants in a lower-income, sub-Saharan population with high rates of pre-ART underweight and tuberculosis (TB) coinfection are unknown. Our analysis included treatment-naïve participants in Kenya and starting their first treatment regimen between January 1, 2015, and September 30, 2018. Participants were grouped into 2 cohorts based on the initial treatment regimen [DTG vs. nonnucleoside reverse transcriptase inhibitors (NNRTI)]. We modelled weight changes over time using a multivariable nonlinear mixed-effect model, with participant as a random effect. Logistic regression models were constructed to evaluate the association between different variables with extreme increase in body mass index (≥10% increase). Seventeen thousand forty-four participants met our inclusion criteria. Sixty-two percent of participants were women, 6% were receiving active TB therapy, and 97% were on NNRTI-based regimens. Participants starting DTG-based regimens were more likely to gain weight when compared with participants starting NNRTI-based regimens. Female participants starting DTG-based regimens experienced the highest weight gain compared with other participants (mean gain of 6.1 kgs at 18 months). Female participants receiving DTG-based regimens, along with participants with lower CD4 cell counts, underweight at baseline, and those receiving active TB therapy were also at higher risk for extreme body mass index increase. Our study in a lower-income sub-Saharan African population confirms higher weight gain with DTG-based regimens compared with traditional ART for treatment-naïve patients.
Sections du résumé
BACKGROUND
Several recent studies have linked integrase strand transfer inhibitors (INSTI) with increased weight gain.
SETTING
The effects of sex on weight gain with dolutegravir (DTG)-based antiretroviral therapy (ART) among treatment-naïve participants in a lower-income, sub-Saharan population with high rates of pre-ART underweight and tuberculosis (TB) coinfection are unknown.
METHODS
Our analysis included treatment-naïve participants in Kenya and starting their first treatment regimen between January 1, 2015, and September 30, 2018. Participants were grouped into 2 cohorts based on the initial treatment regimen [DTG vs. nonnucleoside reverse transcriptase inhibitors (NNRTI)]. We modelled weight changes over time using a multivariable nonlinear mixed-effect model, with participant as a random effect. Logistic regression models were constructed to evaluate the association between different variables with extreme increase in body mass index (≥10% increase).
RESULTS
Seventeen thousand forty-four participants met our inclusion criteria. Sixty-two percent of participants were women, 6% were receiving active TB therapy, and 97% were on NNRTI-based regimens. Participants starting DTG-based regimens were more likely to gain weight when compared with participants starting NNRTI-based regimens. Female participants starting DTG-based regimens experienced the highest weight gain compared with other participants (mean gain of 6.1 kgs at 18 months). Female participants receiving DTG-based regimens, along with participants with lower CD4 cell counts, underweight at baseline, and those receiving active TB therapy were also at higher risk for extreme body mass index increase.
CONCLUSIONS
Our study in a lower-income sub-Saharan African population confirms higher weight gain with DTG-based regimens compared with traditional ART for treatment-naïve patients.
Identifiants
pubmed: 36126175
doi: 10.1097/QAI.0000000000003087
pii: 00126334-202212150-00011
pmc: PMC9814314
mid: NIHMS1834152
doi:
Substances chimiques
dolutegravir
DKO1W9H7M1
Heterocyclic Compounds, 3-Ring
0
Oxazines
0
Pyridones
0
Reverse Transcriptase Inhibitors
0
HIV Integrase Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
490-496Subventions
Organisme : NIAID NIH HHS
ID : U01 AI069911
Pays : United States
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
K.B. reports having received advisory fees and research grant funding from Gilead Sciences. S.K.G. reports having received advisory fees from Gilead Sciences and ViiV Healthcare and an unrestricted grant related to use of dolutegravir from ViiV Healthcare. The remaining authors have no conflicts of interest to disclose.
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