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Brief Report: Weight Gain in Persons With HIV Switched From Efavirenz-Based to Integrase Strand Transfer
Jamison Norwood1, Megan Turner, Carmen Bofill
1*Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; †Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN; ‡Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN; and §Department of Medicine, Meharry Medical College, Nashville, TN.
Journal of Acquired Immune Deficiency Syndromes (1999)
|August 22, 2017
Summary
Switching to integrase strand transfer inhibitor (INSTI)-based HIV therapy led to significant weight gain in adults with viral suppression. This weight gain was most pronounced in patients taking dolutegravir/abacavir/lamivudine (DTG/ABC/3TC).
Area of Science:
- Infectious Diseases
- Pharmacology
- HIV/AIDS Research
Background:
- Integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy offers a potent treatment option for people living with HIV.
- Clinical observations indicated potential weight gain in patients switching from efavirenz/tenofovir disoproxil fumarate/emtricitabine (EFV/TDF/FTC) to INSTI regimens.
Purpose of the Study:
- To evaluate weight changes in patients with sustained virologic suppression after switching from EFV/TDF/FTC to an INSTI-containing regimen.
- To compare weight change between INSTI-based regimens and protease inhibitor (PI)-based regimens.
Main Methods:
- A retrospective observational cohort study was conducted.
- Adults on EFV/TDF/FTC for at least 2 years with virologic suppression were assessed.
- Weight change was measured over 18 months for patients switching to INSTI or PI regimens versus those remaining on EFV/TDF/FTC.
Main Results:
- Patients switching to an INSTI regimen gained an average of 2.9 kg at 18 months (P = 0.003) compared to 0.9 kg for those on EFV/TDF/FTC.
- Switching to a PI regimen resulted in a 0.7 kg gain (P = 0.81).
- The DTG/ABC/3TC regimen showed the most significant weight gain (5.3 kg, P = 0.001) among INSTI regimens.
Conclusions:
- Adults with HIV on viral suppression experienced significant weight gain after switching to INSTI-based therapy.
- The observed weight gain was most substantial in patients who switched to DTG/ABC/3TC.
- This highlights a potential metabolic side effect associated with INSTI-based HIV treatment regimens.
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