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Factors Associated With Weight Change After Continuing or Switching to a Doravirine-based Regimen
Chloe Orkin1, John R Koethe2, Princy N Kumar3
1SHARE Collaborative, Blizard Institute, Queen Mary University of London, London, UK.
Open Forum Infectious Diseases
|November 24, 2025
Summary
Switching to doravirine-based regimens for HIV-1 treatment was generally weight neutral. However, weight changes varied by patient demographics and the prior antiretroviral regimen
Area of Science:
- Infectious Diseases
- Virology
- Clinical Pharmacology
Background:
- Examined weight change factors in adults with HIV-1 on doravirine-based antiretroviral therapy.
- Phase 3 studies (DRIVE-FORWARD, DRIVE-AHEAD, DRIVE-SHIFT) evaluated doravirine continuation or switch.
Purpose of the Study:
- To analyze factors associated with weight change (loss, stable, gain) after switching to or continuing doravirine-based regimens.
- To understand the impact of demographics and prior antiretroviral therapy on weight changes.
Main Methods:
- Randomized controlled trials involving doravirine, darunavir/ritonavir, efavirenz, and nucleos(t)ide reverse transcriptase inhibitors (NRTIs).
- Generalized logistic models analyzed weight change categories (loss ≥5%, stable <5%, gain ≥5%).
- Evaluated continuation vs. switch to doravirine over 96 weeks.
Main Results:
- Most participants (74%) on doravirine also received tenofovir disoproxil fumarate (TDF) and maintained stable weight (57%).
- Weight loss or stable weight was more common in non-Black participants compared to Black participants.
- Switching from weight-suppressive non-nucleoside reverse transcriptase inhibitors (NNRTIs) was associated with weight gain.
Conclusions:
- Switching to doravirine was weight neutral overall, but individual outcomes depend on demographics and prior regimen.
- Further research in underrepresented populations is needed to fully explain observed weight change patterns.
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