TY - JOUR
T1 - Brief Report
T2 - Weight Gain Following ART Initiation in ART-Naïve People Living With HIV in the Current Treatment Era
AU - Ruderman, Stephanie A.
AU - Crane, Heidi M.
AU - Nance, Robin M.
AU - Whitney, Bridget M.
AU - Harding, Barbara N.
AU - Mayer, Kenneth H.
AU - Moore, Richard D.
AU - Eron, Joseph J.
AU - Geng, Elvin
AU - Mathews, William C.
AU - Rodriguez, B.
AU - Willig, Amanda L.
AU - Burkholder, Greer A.
AU - Lindström, Sara
AU - Wood, Brian R.
AU - Collier, Ann C.
AU - Vannappagari, Vani
AU - Henegar, Cassidy
AU - Van Wyk, Jean
AU - Curtis, Lloyd
AU - Saag, Michael S.
AU - Kitahata, Mari M.
AU - Delaney, Joseph A.C.
N1 - Funding Information:
Funding was provided by ViiV Healthcare. ViiV had no influence on data collection, analysis, or decision to publish. ViiV co-authors provided input on interpretation and suggestions for critical revisions of the draft but all final decisions on content were made by S.A.R., J.A.C.D., and H.C. CNICS is funded by the National Institutes of Health who had no role in study design or the manuscript. The corresponding author had access to data and bears responsibility for the manuscript. Additional support came from the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health [CNICS R24 AI067039, UW CFAR NIAID Grant P30 AI027757; UNC CFAR grant P30 AI50410, JHU CFAR grant P30 AI094189, and UAB CFAR grant P30 AI027767] and the National Institute of Drug Abuse R01DA047045.
Publisher Copyright:
© 2020 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Objectives:Evaluate differences in weight change by regimen among people living with HIV (PLWH) initiating antiretroviral therapy (ART) in the current era.Methods:Between 2012 and 2019, 3232 ART-naïve PLWH initiated ≥3-drug ART regimens in 8 Centers for AIDS Research Network of Integrated Clinical Systems sites. We estimated weight change by regimen for 11 regimens in the immediate (first 6 months) and extended (all follow-up on initial regimen) periods using linear mixed models adjusted for time on regimen, interaction between time and regimen, age, sex, race/ethnicity, hepatitis B/C coinfection, nadir CD4, smoking, diabetes, antipsychotic medication, and site. We included more recently approved regimens [eg, with tenofovir alafenamide fumarate (TAF)] only in the immediate period analyses to ensure comparable follow-up time.Results:Mean follow-up was 1.9 years on initial ART regimen. In comparison to efavirenz/tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC), initiating bictegravir/TAF/FTC {3.9 kg [95% confidence interval (CI): 2.2 to 5.5]} and dolutegravir/TAF/FTC [4.4 kg (95% CI: 2.1 to 6.6)] were associated with the greatest weight gain in the immediate period, followed by darunavir/TDF/FTC [3.7 kg (95% CI: 2.1 to 5.2)] and dolutegravir/TDF/FTC [2.6 kg (95% CI: 1.3 to 3.9)]. In the extended period, compared with efavirenz/TDF/FTC, initiating darunavir/TDF/FTC was associated with a 1.0 kg (95% CI: 0.5 to 1.5) per 6-months greater weight gain, whereas dolutegravir/abacavir/FTC was associated with a 0.6-kg (95% CI: 0.3 to 0.9) and dolutegravir/TDF/FTC was associated with a 0.6-kg (95% CI: 0.1 to 1.1) per 6-months greater gain. Weight gain on dolutegravir/abacavir/FTC and darunavir/TDF/FTC was significantly greater than that for several integrase inhibitor-based regimens.Conclusions:There is heterogeneity between regimens in weight gain following ART initiation among previously ART-naïve PLWH; we observed greater gain among PLWH taking newer integrase strand transfer inhibitors (DTG, BIC) and DRV-based regimens.
AB - Objectives:Evaluate differences in weight change by regimen among people living with HIV (PLWH) initiating antiretroviral therapy (ART) in the current era.Methods:Between 2012 and 2019, 3232 ART-naïve PLWH initiated ≥3-drug ART regimens in 8 Centers for AIDS Research Network of Integrated Clinical Systems sites. We estimated weight change by regimen for 11 regimens in the immediate (first 6 months) and extended (all follow-up on initial regimen) periods using linear mixed models adjusted for time on regimen, interaction between time and regimen, age, sex, race/ethnicity, hepatitis B/C coinfection, nadir CD4, smoking, diabetes, antipsychotic medication, and site. We included more recently approved regimens [eg, with tenofovir alafenamide fumarate (TAF)] only in the immediate period analyses to ensure comparable follow-up time.Results:Mean follow-up was 1.9 years on initial ART regimen. In comparison to efavirenz/tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC), initiating bictegravir/TAF/FTC {3.9 kg [95% confidence interval (CI): 2.2 to 5.5]} and dolutegravir/TAF/FTC [4.4 kg (95% CI: 2.1 to 6.6)] were associated with the greatest weight gain in the immediate period, followed by darunavir/TDF/FTC [3.7 kg (95% CI: 2.1 to 5.2)] and dolutegravir/TDF/FTC [2.6 kg (95% CI: 1.3 to 3.9)]. In the extended period, compared with efavirenz/TDF/FTC, initiating darunavir/TDF/FTC was associated with a 1.0 kg (95% CI: 0.5 to 1.5) per 6-months greater weight gain, whereas dolutegravir/abacavir/FTC was associated with a 0.6-kg (95% CI: 0.3 to 0.9) and dolutegravir/TDF/FTC was associated with a 0.6-kg (95% CI: 0.1 to 1.1) per 6-months greater gain. Weight gain on dolutegravir/abacavir/FTC and darunavir/TDF/FTC was significantly greater than that for several integrase inhibitor-based regimens.Conclusions:There is heterogeneity between regimens in weight gain following ART initiation among previously ART-naïve PLWH; we observed greater gain among PLWH taking newer integrase strand transfer inhibitors (DTG, BIC) and DRV-based regimens.
KW - HIV
KW - antiretroviral therapy
KW - bictegravir
KW - dolutegravir
KW - integrase strand transfer inhibitors
KW - weight
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U2 - 10.1097/QAI.0000000000002556
DO - 10.1097/QAI.0000000000002556
M3 - Article
C2 - 33148997
AN - SCOPUS:85102090548
SN - 1525-4135
VL - 86
SP - 339
EP - 343
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 3
ER -