Amutuhaire Willington, Castelnuovo Barbara, Brusselaers Nele, Nabwana Martin, Muhammad Lal, Maloney Brendan, Nixon Bridgette, Schwarz Jean-Marc, Mulindwa Frank
Yale School of Medicine, Department of Cardiology, Connecticut, United States of America.
Infectious Diseases Institute, Makerere University Kampala, Uganda.
PLoS One. 2025 Jun 11;20(6):e0325020. doi: 10.1371/journal.pone.0325020. eCollection 2025.
Most people living with HIV in low and middle-income countries are taking fixed dose combination tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD). Dolutegravir use has been associated with weight gain, a known risk factor for hypertension. We aimed to determine if weight gain in Ugandan anti-retroviral therapy (ART) naïve patients on TLD correlated with increase in blood pressure.
We analyzed data from the 'Glucose metabolism changes in Ugandan persons with HIV (PLHIV) on Dolutegravir (GLUMED)' study which was a prospective cohort study with ART naïve persons with HIV ≥ 18 years followed up on TLD over 48 weeks. A scatter plot with 95% confidence intervals and regression line illustrating the relationship between weight change and mean arterial pressure (MAP) change from baseline to 48 weeks was created. To further examine the effect of weight change on MAP, we performed a linear regression analysis, with MAP change as the dependent variable and weight change as the independent variable.
Of the 220 patients' data analyzed, 129 (58.6%) were female, the median baseline age was 31 years (interquartile range (IQR): 27.0-38.0), the median baseline CD4 cell count was 319 cells/mm3 (IQR 160.0-524.0). The median weight gain over 48 weeks was 3.0 (IQR: -0.1-6.3). We found a moderate positive linear relationship between weight gain and MAP over 48 weeks. For every increase in weight of 1 kg over 48 weeks, there was an adjusted increase in MAP by 0.62mmHG.
We provide additional evidence to suggest that the noticed weight gain after starting dolutegravir based ART may be associated with a heightened risk of incident hypertension.
在低收入和中等收入国家，大多数感染艾滋病毒的人正在服用固定剂量复方制剂替诺福韦酯/拉米夫定/多替拉韦（TLD）。使用多替拉韦与体重增加有关，而体重增加是高血压的一个已知风险因素。我们旨在确定乌干达未接受过抗逆转录病毒治疗（ART）且服用TLD的患者体重增加是否与血压升高相关。
我们分析了“乌干达感染艾滋病毒者（PLHIV）使用多替拉韦后的葡萄糖代谢变化（GLUMED）”研究的数据，该研究是一项前瞻性队列研究，对年龄≥18岁、未接受过ART的艾滋病毒感染者进行了48周的TLD随访。绘制了一个带有95%置信区间和回归线的散点图，以说明从基线到48周体重变化与平均动脉压（MAP）变化之间的关系。为了进一步研究体重变化对MAP的影响，我们进行了线性回归分析，以MAP变化作为因变量，体重变化作为自变量。
在分析的220例患者数据中，129例（58.6%）为女性，基线年龄中位数为31岁（四分位间距（IQR）：27.0 - 38.0），基线CD4细胞计数中位数为319个细胞/mm³（IQR 160.0 - 524.0）。48周内体重增加的中位数为3.0（IQR： - 0.1 - 6.3）。我们发现48周内体重增加与MAP之间存在中度正线性关系。在这48周内，体重每增加1千克，MAP经调整后增加0.62mmHg。
我们提供了更多证据表明，开始基于多替拉韦的抗逆转录病毒治疗后出现的体重增加可能与新发高血压风险增加有关。
