Guaraldi Giovanni, Calza Stefano, Milic Jovana, Calcagno Andrea, Focà Emanuele, Rota Matteo, Renzetti Stefano, Celotti Anna, Siano Matteo, Celesia Benedetto Maurizio, Piconi Stefania, de Socio Giuseppe Vittorio, Cattelan Anna Maria, Orofino Giancarlo, Riva Agostino, Nozza Silvia, di Perri Giovanni
Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena.
Department of Molecular and Translational Medicine, University of Brescia, Brescia.
AIDS. 2021 May 1;35(6):939-945. doi: 10.1097/QAD.0000000000002853.
The aim of this study was to explore weight gain in people with HIV (PWH) at least 65 years of age who switch to a DTG based regimen (DTG-s) vs. remaining INSTI-naive (INSTI-n) on stable ART.
This was a longitudinal prospective study of PWH from the GEPPO cohort. At the beginning of the observational period, participants were INSTI-naives (INSTI-n). During follow-up, they were divided in two groups: INSTI-n vs. dolutegravir-switchers (DTG-s) with no further change in ART. Body weight was assessed at baseline and at last follow-up visit. Significant weight gain was defined as an increase at least 5% of baseline weight from the first to the last visit. ART regimens were collected at each patients' visit. Kaplan--Meier curves were drawn to assess time to reach a weight gain more than 5%.
Out of 568 PWH (83.1% men, median age 69.5 years), 427 (75%) were INSTI-n and 141 (25%) DTG-s. After an average follow-up of 2.6 (±0.8) years, no significant change in body weight was observed both among INSTI-n [delta weight = 0.02 (±7.5), P = 0.633] and DTG-s [delta weight = -0.04 (±5.2), P = 0.755]. Weight gain was also not significantly different between study groups (9.3% in INSTI-n and 15.1% in DTG-S: P = 0.175). No significant differences in time to achieve a weight gain greater or equal than 5% of baseline weight emerged in INSTI-n vs. DTG-s (P = 0.93), two-drug regimens (2DR) vs. three-drug regimens (3DR) (P = 0.56) or TAF vs. TDF (P = 0.56).
Results from a large Italian cohort did not show a significant weight gain associated with switch to DTG in PWH 65 years of age or older. This finding emerged also when comparing 3DR vs. 2DR and TAF exposed and unexposed geriatric PWH.
本研究旨在探讨65岁及以上的HIV感染者（PWH）从稳定的抗逆转录病毒治疗（ART）转换为基于多替拉韦（DTG）的治疗方案（DTG-s）与维持初始整合酶链转移抑制剂（INSTI）治疗（INSTI-n）者的体重增加情况。
这是一项对GEPPO队列中的PWH进行的纵向前瞻性研究。在观察期开始时，参与者为初始使用INSTI者（INSTI-n）。在随访期间，他们被分为两组：INSTI-n组与转换为多替拉韦治疗者（DTG-s）组，ART方案不再有进一步变化。在基线和最后一次随访时评估体重。显著体重增加定义为从首次访视到最后一次访视体重增加至少5%。在每次患者访视时收集ART方案。绘制Kaplan-Meier曲线以评估体重增加超过5%的时间。
在568例PWH中（83.1%为男性，中位年龄69.5岁），427例（75%）为INSTI-n，141例（25%）为DTG-s。平均随访2.6（±0.8）年后，INSTI-n组[体重变化量=0.02（±7.5），P=0.633]和DTG-s组[体重变化量=-0.04（±5.2），P=0.755]的体重均未观察到显著变化。研究组之间的体重增加也无显著差异（INSTI-n组为9.3%，DTG-S组为15.1%：P=0.175）。INSTI-n组与DTG-s组相比（P=0.93）、双药方案（2DR）与三药方案（3DR）相比（P=0.56）或替诺福韦艾拉酚胺（TAF）与替诺福韦酯（TDF）相比（P=0.56），在达到体重增加大于或等于基线体重5%的时间方面均无显著差异。
来自一个大型意大利队列的结果显示，65岁及以上的PWH转换为DTG治疗与体重显著增加无关。在比较3DR与2DR以及暴露与未暴露于TAF的老年PWH时，也出现了这一结果。
