西班牙南部一组HIV阳性患者一线抗逆转录病毒治疗开始后的体重变化（CAPOTA研究）。
Weight changes after first-line antiretroviral initiation in a cohort of HIV-positive patients in Southern Spain (CAPOTA study).
作者信息
Gómez-Ayerbe Cristina, Palacios Rosario, Mayorga Marisa, Navarrete Miguel Nicolas, Ferra Sergio, Ruiz Inmaculada, Garcia Coral, Castaño Manuel, Merino Dolores, Collado Antonio, Hidalgo-Tenorio Carmen, Delgado Marcial, Rivero Antonio, Santos Jesús
机构信息
16867Hospital Virgen de La Victoria e IBIMA, Málaga, Spain.
16330Hospital Regional Carlos Haya, Málaga, Spain.
出版信息
Int J STD AIDS. 2022 Nov;33(13):1119-1123. doi: 10.1177/09564624221125356. Epub 2022 Sep 7.
BACKGROUND
Obesity among persons living with HIV (PLWH) has increased and weight gain after antiretroviral therapy (ART) can lead to metabolic disorders and impact survival. Our objective was to analyze weight and metabolic changes in HIV näive patients after 48 weeks of ART.
METHODS
Observational, retrospective, multicentered cohort study comprising naïve-patients who started tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) or abacavir/lamivudine/dolutegravir (ABC/3TC/DTG), with no change in treatment for 48 weeks. Clinical and metabolic parameters were collected at baseline and week-48. Statistical program used was SPSS 21.0.0.
RESULTS
The study included 329 participants from 6 hospitals. Participants were 89% male and 10% had AIDS diagnosis. Median age was 35 (IQR 27-43) years. Median baseline CD4 count was 417 (IQR 250-569) cell/mm3 and HIV viral load 4.65 (IQR 4.21-5.18) log copies/ml. Baseline median weight was 70 (IQR 62-79) kg, body mass index 23.4 (IQR 21.2-26.0) kg/m2; 22.7% overweight and 6.4% obese. ART regimens: ABC/3TC/DTG (196), TAF/FTC/EVG/c (133). Baseline characteristics were similar in both ART groups. Average weight gain at week-48 was 2.9 (SD 5.5) kg ( < 0.0001) with no differences between both groups. There was an increase in obesity (6.4%-8%; < 0.003) and overweight (22.7%-28.9%; < 0.0001). Weight increase was associated with AIDS: OR 3.05 (95%; CI 1.009-9.22), = 0.048; and lower baseline weight: OR 1.032 (95% CI 1.009-1.05), = 0.006.
CONCLUSIONS
After ART initiation patients gain weight regardless of the regimen they take. Weight gain is associated with AIDS and the use of TAF/FTC/EVG/c.
背景
感染人类免疫缺陷病毒（HIV）者（PLWH）的肥胖率有所上升，抗逆转录病毒疗法（ART）后的体重增加会导致代谢紊乱并影响生存。我们的目标是分析初治HIV患者接受48周ART后的体重和代谢变化。
方法
一项观察性、回顾性、多中心队列研究，纳入开始使用替诺福韦艾拉酚胺/恩曲他滨/埃替拉韦/考比司他（TAF/FTC/EVG/c）或阿巴卡韦/拉米夫定/多替拉韦（ABC/3TC/DTG）且48周内治疗方案不变的初治患者。在基线和第48周收集临床和代谢参数。使用的统计软件为SPSS 21.0.0。
结果
该研究纳入了来自6家医院的329名参与者。参与者中89%为男性，10%已确诊患有艾滋病。中位年龄为35（四分位间距27 - 43）岁。基线CD4细胞计数中位数为417（四分位间距250 - 569）个/mm³，HIV病毒载量为4.65（四分位间距4.21 - 5.18）log拷贝/ml。基线体重中位数为70（四分位间距62 - 79）kg，体重指数为23.4（四分位间距21.2 - 26.0）kg/m²；22.7%超重，6.4%肥胖。ART方案：ABC/3TC/DTG（196例），TAF/FTC/EVG/c（133例）。两个ART组的基线特征相似。第48周时平均体重增加2.9（标准差5.5）kg（P < 0.0001），两组间无差异。肥胖率有所上升（6.4% - 8%；P < 0.003），超重率也上升（22.7% - 28.9%；P < 0.0001）。体重增加与艾滋病相关：比值比3.05（95%置信区间1.009 - 9.22），P = 0.048；与较低的基线体重相关：比值比1.032（95%置信区间1.009 - 1.05），P = 0.006。
结论
开始ART治疗后，无论采用何种方案，患者体重都会增加。体重增加与艾滋病以及TAF/FTC/EVG/c的使用有关。
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