Division of Infectious Diseases, University of Texas Health Science Center, Houston, Texas, USA.
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia.
Curr Opin HIV AIDS. 2021 May 1;16(3):148-151. doi: 10.1097/COH.0000000000000680.
Obesity is increasing in people with HIV (PWH). This review aims to summarise the recent evidence investigating the associations between the use of integrase inhibitors and tenofovir alafenamide (TAF) with weight gain and the mechanisms by which this may occur. Understanding the role that antiretroviral therapies play in promoting weight gain is critical in making informed treatment decisions.
Weight gain is common with antiretroviral therapies and can lead to significant medical complications for PWH. Antiretroviral regimens containing an integrase inhibitor in conjunction with TAF are associated with the greatest degree of weight gain. This weight gain is greatest with dolutegravir and bictegravir compared with other integrase inhibitors. Some of the measured weight gain attributed to TAF may actually reflect a loss of weight suppressant effects of tenofovir disoproxil fumarate, and thus the exact proportional contribution of TAF remains to be seen. The mechanisms by which advent of antiretroviral therapy may be promoting weight gain is still being determined but underlying genetic risks factors and gender are very important determinants of the degree of weight gained.
Integrase inhibitors and TAF contribute to weight gain in PWH. This places them at risk for potentially serious medical complications.
HIV 感染者（PWH）的肥胖率正在上升。本综述旨在总结最近有关整合酶抑制剂和替诺福韦艾拉酚胺（TAF）与体重增加之间关联的研究证据，并探讨可能的发生机制。了解抗逆转录病毒疗法在促进体重增加方面的作用对于做出明智的治疗决策至关重要。
抗逆转录病毒疗法常导致体重增加，这会给 PWH 带来严重的医疗并发症。含有整合酶抑制剂和 TAF 的抗逆转录病毒方案与最大程度的体重增加相关。与其他整合酶抑制剂相比，多替拉韦和比克替拉韦会导致更大程度的体重增加。部分归因于 TAF 的体重增加实际上可能反映了替诺福韦二吡呋酯的体重抑制作用的丧失，因此 TAF 的确切比例贡献仍有待观察。抗逆转录病毒疗法促进体重增加的机制仍在确定中，但潜在的遗传风险因素和性别是体重增加程度的重要决定因素。
整合酶抑制剂和 TAF 会导致 PWH 的体重增加，这使他们面临潜在严重医疗并发症的风险。
