Weight gain in HIV-infected patients

Area of Science:

• Infectious Diseases
• Metabolic Disorders
• Pharmacology

Background:

• HIV infection is associated with metabolic changes, initially concerning weight loss and lipodystrophy.
• Current effective antiretroviral therapies (ART) are linked to paradoxical weight gain in people living with HIV (PLWH).

Purpose of the Study:

• To investigate the association between specific antiretroviral drugs and weight gain in PLWH.
• To explore potential contributing factors and mechanisms behind ART-associated weight gain.
• To understand the clinical implications of abnormal weight gain in the context of HIV management.

Main Methods:

• Analysis of clinical trials and real-world cohorts evaluating weight changes in PLWH on ART.
• Examination of demographic factors (sex, ethnicity) and specific drug classes (integrase inhibitors, tenofovir disoproxil fumarate) in relation to weight gain.
• Review of proposed mechanisms of action for ART-induced weight gain.

Main Results:

• Integrase inhibitors (dolutegravir, bictegravir) and female sex/African/American origin are associated with increased weight gain.
• Tenofovir disoproxil fumarate may act as a protective factor against weight gain.
• The precise mechanisms driving ART-associated weight gain remain unclear.

Conclusions:

• Antiretroviral treatment, particularly certain integrase inhibitors, is a significant factor in abnormal weight gain among PLWH.
• Further research is needed to elucidate the mechanisms and clinical significance of this weight gain, especially concerning comorbidities like diabetes and cardiovascular events.