Lahiri Cecile D, Mehta C Christina, Yang Qian, Maramba Tsungirirai, Musonge-Effoe Joffi, Yang Chin-An, Dumond Julie B, Alcaide Maria L, Lake Jordan E, Rubin Leah H, French Audrey L, Cocohoba Jennifer, Kassaye Seble G, Sharma Anjali, Palella Frank J, Mellors John, Konkle-Parker Deborah, Topper Elizabeth, Augenbraun Michael, Ali Mohammed K, Sheth Anandi N, Ziegler Thomas R, Ofotokun Igho, Alvarez Jessica A
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Laney Graduate School, Emory University, Atlanta, Georgia, USA.
Clin Infect Dis. 2025 Mar 17;80(3):575-584. doi: 10.1093/cid/ciae474.
Sex-specific, long-term, body weight change in persons with human immunodeficiency virus (PWH) following switch to regimens containing integrase strand transfer inhibitors (INSTIs) is unknown.
We compared PWH enrolled in the MACS/WIHS Combined Cohort Study (2007-2020) who switched/added an INSTI to their antiretroviral therapy (ART) regimen to those remaining on non-INSTI ART and to people without human immunodeficiency virus (PWOH), by sex. Follow-up time was time since switch visit (or comparable visit in controls). Linear regression mixed-effects models assessed the effects of sex, group, and time upon weight and anthropometric measurements.
Of 3464 participants included, women (411 INSTI, 709 non-INSTI, 818 PWOH) compared to men (223 INSTI, 412 non-INSTI, 891 PWOH) were younger (47.2 vs 54.5 years), were majority non-Hispanic Black (65% vs 23%), and had higher mean body mass index (31.5 vs 26.9 kg/m2), respectively. Women switching to INSTIs experienced greater absolute and percentage weight gain compared to men at 5 years: +3.0 kg (95% confidence interval [CI], 2.1-3.9) versus +1.8 kg (95% CI, .7-2.9) and +4.6% (95% CI, 3.5%-5.7%) versus +2.3% (95% CI, 1.0%-3.6%), respectively ([sex × time × group interaction, P < .01). Compared to men, women switching to INSTIs experienced greater hip and thigh circumference gain at 5 years: +2.6 cm (95% CI, 1.6-3.6) versus +1.2 cm (95% CI, .3-2.1) and +1.5 cm (95% CI, .7-2.2) versus -0.2 cm (95% CI, -.9 to .5), respectively.
Weight change among PWH over 5 years after switch to INSTI was 2-fold higher in women than men. The cardiometabolic implications of this difference in weight gain remain unknown.
切换至含整合酶链转移抑制剂（INSTIs）方案的人类免疫缺陷病毒感染者（PWH）的性别特异性长期体重变化尚不清楚。
我们比较了参加MACS/WIHS联合队列研究（2007 - 2020年）的PWH，这些患者将INSTI切换/添加到其抗逆转录病毒治疗（ART）方案中，与仍采用非INSTI ART方案的患者以及未感染人类免疫缺陷病毒的人群（PWOH），按性别进行比较。随访时间为自切换访视（或对照组的可比访视）后的时间。线性回归混合效应模型评估性别、组和时间对体重及人体测量指标的影响。
在纳入的3464名参与者中，女性（411名使用INSTI，709名未使用INSTI，818名PWOH）与男性（223名使用INSTI，412名未使用INSTI，891名PWOH）相比，年龄更小（47.2岁对54.5岁），大多数为非西班牙裔黑人（65%对23%），平均体重指数更高（31.5 kg/m²对26.9 kg/m²）。与男性相比，切换至INSTIs的女性在5年时体重的绝对增加量和百分比增加量更大：分别为+3.0 kg（95%置信区间[CI]，2.1 - 3.9）对+1.8 kg（95% CI，0.7 - 2.9）以及+4.6%（95% CI，3.5% - 5.7%）对+2.3%（95% CI，1.0% - 3.6%）（[性别×时间×组交互作用，P < 0.01]）。与男性相比，切换至INSTIs的女性在5年时髋围和大腿围增加更多：分别为+2.6 cm（95% CI，1.6 - 3.6）对+1.2 cm（95% CI，0.3 - 2.1）以及+1.5 cm（95% CI，0.7 - 2.2）对 - 0.2 cm（95% CI， - 0.9至0.5）。
切换至INSTI后5年，PWH中女性的体重变化比男性高2倍。这种体重增加差异对心脏代谢的影响尚不清楚。
