Al Naimi Ammar, Chang Charlotte, Rawizza Holly, Olaifa Oluwaseun, Ogunsola Olabanjo, Okonkwo Prosper, Kanki Phyllis
Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Obstetrics and Gynecology, Buergerhospital, Nibelungenallee 37-41, 60318, Frankfurt Am Main, Germany.
AIDS Res Ther. 2025 Mar 24;22(1):38. doi: 10.1186/s12981-025-00731-x.
Weight change for women living with HIV (WLWH) who receive dolutegravir (DTG) is understudied around pregnancy. The aim of this study was to investigate the direction and magnitude of weight change among WLWH pre-, during, and post-gestation based on DTG exposure history.
This retrospective cohort study evaluated adult pregnant WLWH receiving antenatal care between 2016 and 2022 at two clinics in Nigeria and followed them over three 9-month periods (pregestational, antenatal, and postgestational). Patients were stratified into three DTG exposure groups for each follow-up period: non-DTG, DTG-switch, and DTG. Three mixed effects models with random intercepts and slopes were utilized to assess the association between DTG and weight. Sensitivity analysis was conducted using binomial DTG exposure with starting time.
The study included 2386 women, 851 (35.7%) of whom used DTG at some point. Average maternal weight was 63.8 ± 12.7 kg, 67.0 ± 13.1 kg, and 64.5 ± 12.7 kg during the pregestational, antenatal, and postgestational period. The weight difference in kg for DTG and DTG-switch compared to other ARTs were 0.06 (-1.66, 1.79) and -2.11 (-5.33, 1.11) pregestational, -0.613 (-2.14, 0.92) and 1.21 (-0.80, 3.21) antepartum, and 2.64 (0.37, 4.91) and 0.89 (-1.40, 3.18) postgestational. The antenatal slope (β) for DTG exposure and initiation time was 0.01 (0.001, 0.02) kg/day.
DTG therapy is associated with more rapid weight gain during pregnancy without significantly affecting the total weight gained. Moreover, retained weight postgestation is higher in women on DTG. Therefore, they could face higher future metabolic and cardiovascular risks.
怀孕前后，接受度鲁特韦（DTG）治疗的感染艾滋病毒女性（WLWH）的体重变化情况鲜少被研究。本研究旨在根据DTG暴露史，调查WLWH在妊娠前、妊娠期间和产后体重变化的方向和幅度。
这项回顾性队列研究评估了2016年至2022年期间在尼日利亚两家诊所接受产前护理的成年怀孕WLWH，并在三个9个月期间（孕前、产前和产后）对她们进行跟踪。在每个随访期，患者被分为三个DTG暴露组：非DTG组、DTG转换组和DTG组。使用三个具有随机截距和斜率的混合效应模型来评估DTG与体重之间的关联。使用二项式DTG暴露和起始时间进行敏感性分析。
该研究纳入了2386名女性，其中851名（35.7%）在某个时间点使用过DTG。孕前、产前和产后期间孕妇的平均体重分别为63.8±12.7千克、67.0±13.1千克和64.5±12.7千克。与其他抗逆转录病毒疗法相比，DTG组和DTG转换组孕前体重差异（千克）分别为0.06（-1.66，1.79）和-2.11（-5.33，1.11），产前分别为-0.613（-2.14，0.92）和1.21（-0.80，3.21），产后分别为2.64（0.37，4.91）和0.89（-1.40，3.18）。DTG暴露和起始时间的产前斜率（β）为0.01（0.001，0.02）千克/天。
DTG治疗与孕期体重更快增加相关，但对总体重增加没有显著影响。此外，接受DTG治疗的女性产后保留的体重更高。因此，她们未来可能面临更高的代谢和心血管风险。
