Department of Internal Medicine, Amsterdam Infection and Immunity Institute and Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Global Health, Amsterdam UMC, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
PLoS One. 2021 May 5;16(5):e0251205. doi: 10.1371/journal.pone.0251205. eCollection 2021.
Recent studies have reported disproportionate weight gain associated with integrase strand transfer inhibitor (INSTI) initiation in antiretroviral therapy(ART)-naive people with HIV (PWH), particularly among black women. We investigated if HIV-positive AGEhIV participants with suppressed viremia switching to INSTI-containing ART experienced more weight gain compared to HIV-positive virally-suppressed non-switching and HIV-negative controls.
In the AGEhIV cohort, standardized weight measurements were performed biennially. Participants switching to INSTI-containing ART were 1:2:2 propensity score-matched with controls by age, gender, ethnicity and body mass index. Mean weight changes and proportions experiencing >5% or >10% weight gain were compared between study-groups using linear mixed-effects models and logistic regression, respectively.
121 INSTI-switching participants and 242 participants from each of the control groups were selected. Across groups, median age was 53-55 years, 83-91% were male and 88-93% white. Mean weight change after switch among INSTI-switching participants was +0.14 kg/year (95%CI -0.25, +0.54) and similar among HIV-positive [+0.13 kg/year (95%CI +0.07, +0.33; P = .9)] and HIV-negative [+0.18 kg/year (95%CI 0.00, +0.37; P = .9)] controls. Weight gain >5% occurred in 28 (23.1%) INSTI-switching, 38 HIV-positive (15.7%, P = .085) and 32 HIV-negative controls (13.2%, P = .018). Weight gain >10% was rare.
Switching to INSTI-containing ART in our cohort of predominantly white men on long-term ART was not associated with greater mean weight gain, but >5% weight gain was more common than in controls. These results suggest that not all, but only certain, PWH may be particularly prone to gain a clinically significant amount of weight as a result of switching to INSTI.
最近的研究报告称，在开始接受抗逆转录病毒疗法（ART）的 HIV 感染者（PWH）中，与整合酶链转移抑制剂（INSTI）相关的体重增加不成比例，尤其是在黑人女性中。我们研究了在病毒载量得到抑制的 HIV 阳性 AGEhIV 参与者中，与未切换组和 HIV 阴性对照组相比，切换到包含 INSTI 的 ART 是否会经历更多的体重增加。
在 AGEhIV 队列中，每两年进行一次标准化体重测量。通过年龄、性别、种族和体重指数，将切换到包含 INSTI 的 ART 的参与者与对照组进行 1:2:2 的倾向评分匹配。使用线性混合效应模型和逻辑回归分别比较研究组之间的平均体重变化和经历体重增加超过 5%或 10%的比例。
选择了 121 名 INSTI 切换参与者和每个对照组的 242 名参与者。在所有组中，中位年龄为 53-55 岁，83-91%为男性，88-93%为白人。INSTI 切换参与者切换后平均体重变化为+0.14kg/年（95%CI-0.25，+0.54），在 HIV 阳性组[+0.13kg/年（95%CI+0.07，+0.33；P=.9）]和 HIV 阴性组[+0.18kg/年（95%CI 0.00，+0.37；P=.9）]中相似。28 名（23.1%）INSTI 切换参与者、38 名 HIV 阳性参与者（15.7%，P=.085）和 32 名 HIV 阴性参与者（13.2%，P=.018）体重增加超过 5%。体重增加超过 10%的情况很少见。
在我们的队列中，主要为白人男性，长期接受 ART 的患者切换到包含 INSTI 的 ART 后，体重平均增加不相关，但体重增加超过 5%的情况比对照组更为常见。这些结果表明，并非所有 HIV 感染者（PWH）都会因切换到 INSTI 而导致体重显著增加，只有某些特定的患者可能会出现这种情况。
