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Updated: Jan 2, 2026
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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
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Weight gain and integrase inhibitors.
Allison Ross Eckard1, Grace A McComsey2
1Division of Infectious Diseases, Medical University of South Carolina, Charleston, South Carolina.
Current Opinion in Infectious Diseases
|December 3, 2019
Summary
Integrase strand transfer inhibitors (INSTIs) used in HIV treatment are linked to significant weight gain and obesity in people living with HIV (PLWH). Further research is needed to understand and prevent this growing concern.
Area of Science:
- HIV/AIDS research
- Pharmacology
- Metabolic disorders
Background:
- Weight gain and obesity are significant concerns for people living with HIV (PLWH).
- Antiretroviral therapy (ART) initiation can contribute to weight gain.
- Integrase strand transfer inhibitors (INSTIs) may exacerbate weight gain in PLWH.
Purpose of the Study:
- To comprehensively review available data on weight gain and obesity in PLWH on ART.
- To summarize current understanding of the role of INSTIs in weight gain and body composition changes.
- To highlight potential risks and areas for future research.
Main Methods:
- Systematic review of existing literature.
- Analysis of clinical data and observational studies.
- Synthesis of findings on INSTI-based regimens and weight changes.
Main Results:
- INSTI-based regimens, particularly those including dolutegravir, are associated with greater weight gain and treatment-emergent obesity compared to non-INSTI regimens.
- Women and nonwhite individuals appear to be at higher risk.
- The role of INSTIs in lipohypertrophy is inconsistent, and the pathogenesis of weight gain remains poorly understood.
- Potential comorbidities include cardiovascular disease and diabetes.
Conclusions:
- INSTI-based regimens, while effective for viral suppression, are linked to increased weight gain and obesity in PLWH.
- This weight gain may elevate the risk of serious comorbidities.
- Further investigation into the mechanisms underlying INSTI-associated weight gain is crucial for developing preventive strategies.
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