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Changes in central adipose tissue after switching to integrase inhibitors
Paula Debroy1, Han Feng1, Hongyu Miao1
1University of Texas Health Sciences Center, Houston, TX, USA.
HIV Research & Clinical Practice
|January 18, 2021
Summary
Switching to integrase strand transfer inhibitor (INSTI) regimens significantly accelerated both subcutaneous (SAT) and visceral adipose tissue (VAT) gain in adults with HIV. Further research is needed to understand INSTI-associated central adiposity.
Area of Science:
- Endocrinology
- Infectious Diseases
- Metabolism
Background:
- Integrase strand transfer inhibitors (INSTIs) are linked to weight gain in HIV patients.
- Long-term effects of INSTI regimens on adipose tissue (AT) compartments are not well understood.
Purpose of the Study:
- To assess the impact of switching to an INSTI on visceral (VAT) and subcutaneous (SAT) adipose tissue in virologically suppressed adults with HIV.
Main Methods:
- Retrospective observational cohort study of 698 HIV-positive adults on antiretroviral therapy (ART).
- Abdominal computed tomography (CT) used for body composition assessment.
- Interrupted time series analysis with mixed-effects models to quantify VAT and SAT changes.
Main Results:
- Switching to an INSTI regimen led to a 3-fold increase in SAT area (0.27 to 0.73 cm²/month) and a 7-fold increase in VAT area (0.18 to 1.30 cm²/month).
- These increases were statistically significant (p=0.011 for SAT, p<0.001 for VAT).
Conclusions:
- INSTI-based regimens are associated with accelerated gains in both SAT and VAT among people living with HIV (PLWH) on ART.
- The relationship between INSTIs and central adiposity warrants additional investigation.
