Avalere Health-An Inovalon Company, Washington, District of Columbia, USA.
Janssen Scientific Affairs, LLC, Titusville, New Jersey, USA.
AIDS Res Hum Retroviruses. 2021 Nov;37(11):834-841. doi: 10.1089/AID.2020.0216. Epub 2021 Oct 26.
Antiretroviral therapies (ARTs) benefit millions with human immunodeficiency virus. However, concerns about subsequent weight gain and related metabolic complications have emerged. Early ARTs are associated with adipose tissue changes. While newer ARTs may have fewer adipose alterations, it is unclear whether they lead to increased weight gain. A systematic literature review was performed to describe current published literature describing the use of newer ARTs, weight gain, and related comorbidities. Titles and abstracts were screened, focusing on studies that examined ART initiation and subsequent weight gain; publications were then ranked based on publication type, methodology, and comorbidities, emphasizing US studies with large patient cohorts. This yielded a comprehensive review of the 50 publications on weight gain and a range of related comorbidities, including diabetes and hypertension. Most of the studies describing weight gain found the most significant gains during the first year after initiating ART. Overall, patients gained ∼5 kg 18-96 months after initiating ART. Many of the studies reported altered weight-related comorbidities, including increased risk of diabetes and hypertension. Despite an expectation that newer ARTs may be safer, a review of the literature suggests that contemporary ART use is associated with pronounced weight gain and related comorbidities. Future studies should define and quantify the direct role of newer ARTs in weight gain and related comorbidities, as well as clarify the role of specific drug classes in metabolic disturbance, to improve intervention strategies.
抗逆转录病毒疗法（ART）使数百万艾滋病毒感染者受益。然而，人们对随后的体重增加和相关代谢并发症的出现表示担忧。早期的抗逆转录病毒疗法与脂肪组织变化有关。虽然更新的抗逆转录病毒疗法可能对脂肪组织的改变较少，但尚不清楚它们是否会导致体重增加。进行了系统的文献综述，以描述当前描述使用新型抗逆转录病毒疗法、体重增加和相关合并症的已发表文献。筛选了标题和摘要，重点关注研究抗逆转录病毒疗法起始和随后体重增加的研究；然后根据出版物类型、方法和合并症对出版物进行排名，强调具有大量患者队列的美国研究。这对 50 篇关于体重增加和一系列相关合并症的研究进行了全面综述，包括糖尿病和高血压。描述体重增加的大多数研究发现，在开始抗逆转录病毒疗法后的第一年体重增加最明显。总体而言，患者在开始抗逆转录病毒疗法 18-96 个月后体重增加了约 5 公斤。许多研究报告了与体重相关的合并症的改变，包括糖尿病和高血压风险增加。尽管人们期望新型抗逆转录病毒疗法可能更安全，但文献回顾表明，当代抗逆转录病毒疗法的使用与明显的体重增加和相关合并症有关。未来的研究应确定和量化新型抗逆转录病毒疗法在体重增加和相关合并症中的直接作用，以及明确特定药物类别在代谢紊乱中的作用，以改善干预策略。
