Changes in weight and BMI with first-line doravirine-based therapy

Area of Science:

• Infectious Diseases
• Virology
• Metabolic Health

Background:

• Antiretroviral therapy (ART) is crucial for managing HIV-1 infection.
• Understanding weight and BMI changes during ART is important for long-term patient health.
• Previous studies suggest potential weight gain differences among various ART regimens.

Purpose of the Study:

• To compare weight and body mass index (BMI) changes in adults with HIV-1.
• To evaluate these changes at 1 and 2 years after initiating ART with doravirine, ritonavir-boosted darunavir, or efavirenz.
• To identify risk factors for weight gain and associated metabolic outcomes.

Main Methods:

• Post-hoc analysis of pooled data from three randomized controlled trials.
• Evaluation of weight change from baseline, significant weight gain (≥10%), and BMI class increase at 48 and 96 weeks.
• Examination of risk factors for weight gain and metabolic outcomes.

Main Results:

• Mean weight changes were similar across all treatment groups by week 96 (doravirine: 2.4 kg, ritonavir-boosted darunavir: 1.8 kg, efavirenz: 1.6 kg).
• No significant differences were observed in the proportion of participants experiencing ≥10% weight gain or BMI class increase between groups.
• Low baseline CD4 T-cell count and high baseline HIV-1 RNA were associated with significant weight gain and BMI increase.

Conclusions:

• Weight gain over 96 weeks was generally low and comparable across the studied ART regimens.
• Weight changes were similar to those observed in non-HIV-infected adults.
• Significant weight gain and BMI class increase were predicted by baseline immunological and virological status, not the specific ART regimen.