Patel Yesha S, Doshi Anjali D, Levesque Anna E, Lindor Shelsie, Moranville Robert D, Okere Sheila C, Robinson Danielle B, Taylor Lauren, Lustberg Mark E, Malvestutto Carlos D
Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
College of Medicine, The Ohio State University, Columbus, Ohio, USA.
AIDS Res Hum Retroviruses. 2023 Dec;39(12):652-661. doi: 10.1089/AID.2023.0008. Epub 2023 Jun 29.
We explored factors associated with weight gain among people with HIV (PWH) on antiretroviral therapy (ART) at The Ohio State University Wexner Medical Center (OSUWMC). This was a retrospective cohort study of adult PWH on ART for ≥3 months. Patients with CD4 T cell count <200 cells/mm, viral load >200 copies/mL, history of malignancy, or pregnancy were excluded. Eight hundred seventy patients met criteria. The primary outcome was percent weight change over the follow-up period (Δ = relative effects). The secondary outcome was the odds of ≥5 kg weight gain over the study period. The effects of concurrent medications, medical comorbidities, ART combinations, and lifestyle behaviors on these outcomes were modeled using mixed effects regression analyses. Over a mean follow-up of 1.86 years, the study population gained a mean percent weight of 2.12% ± 0.21% ( < .001) with the odds of ≥5 kg weight gain of 0.293 ( < .001). Males gained an average of 1.88% ± 0.22% over follow up, while females gained an average of 3.37% ± 0.51% over follow up ( = .008 for the difference). In regression models, combination therapy with tenofovir alafenamide (TAF) and integrase strand transfer inhibitor (INSTI) containing regimens was associated with an increase in weight over the study period (Δ = 2.14% ± 0.45%, < .001 and Δ = 1.09% ± 0.39%, = .005, respectively). Increasing age was significantly associated with a decrease in percent weight change over the study period (Δ = -0.68% ± 0.18% per year, < .001). Self-reported improvement in diet was associated with a decrease in weight change (Δ = -1.99% ± 0.47%, ≤ .001) and reduced odds of ≥5 kg weight gain (odds ratio = 0.70, 95% confidence interval = 0.50-0.97, = .03). Factors associated with weight gain include therapy with TAF and INSTI. Diet may play an influential role in attenuating weight gain in PWH.
我们在俄亥俄州立大学韦克斯纳医学中心（OSUWMC）对接受抗逆转录病毒治疗（ART）的艾滋病毒感染者（PWH）中与体重增加相关的因素进行了探究。这是一项针对接受ART治疗≥3个月的成年PWH的回顾性队列研究。排除了CD4 T细胞计数<200个细胞/mm、病毒载量>200拷贝/mL、有恶性肿瘤病史或怀孕的患者。870名患者符合标准。主要结局是随访期间体重变化百分比（Δ=相对效应）。次要结局是研究期间体重增加≥5kg的几率。使用混合效应回归分析对同时使用的药物、合并症、ART组合和生活方式行为对这些结局的影响进行建模。在平均1.86年的随访中，研究人群体重平均增加了2.12%±0.21%（P<0.001），体重增加≥5kg的几率为0.293（P<0.001）。男性随访期间平均增加了1.88%±0.22%，而女性随访期间平均增加了3.37%±0.51%（差异P=0.008）。在回归模型中，替诺福韦艾拉酚胺（TAF）与含整合酶链转移抑制剂（INSTI）的联合治疗方案与研究期间体重增加有关（Δ=2.14%±0.45%，P<0.001和Δ=1.09%±0.39%，P=0.005）。年龄增加与研究期间体重变化百分比的降低显著相关（每年Δ=-0.68%±0.18%，P<0.001）。自我报告的饮食改善与体重变化减少有关（Δ=-1.99%±0.47%，P≤0.001）以及体重增加≥5kg的几率降低（优势比=0.70，95%置信区间=0.50-0.97，P=0.03）。与体重增加相关的因素包括TAF和INSTI治疗。饮食可能在减轻PWH体重增加方面发挥重要作用。
