December 03, 2020
2 min learn
Patel Y, et al. Poster 951. Introduced at: IDWeek; Oct. 21-25, 2020 (digital assembly).
Patel reviews no related monetary disclosures.
In a cohort of sufferers with HIV, weight acquire was linked to the usage of sure varieties of ART, in addition to a baseline prognosis of hypertension, a researcher reported at IDWeek.
“Weight problems is a public well being disaster with a rising prevalence in individuals with HIV,” Yesha Patel, MD, an infectious illness fellow at The Ohio State College Wexner Medical Heart, mentioned throughout a poster presentation.
Patel famous that some ART regimens, together with integrase inhibitor-based regimens, have been related to an elevated threat for creating weight problems, however different components may be linked to weight gain in this patient population.
The retrospective single-center research included a randomized pattern of 300 adults with HIV, excluding pregnant sufferers and people aged older than 100 years, who have been seen between 2015 and 2019 at The Ohio State College’s outpatient infectious illness clinic. All had a confirmed prognosis of HIV, had at the very least two follow-up clinic visits, have been on ART for 3 months and had proof of viral suppression.
Weight change over time served as the first consequence. Secondary outcomes included the affiliation of weight change with demographics, insurance coverage standing, comorbid situations and concurrent drugs.
At baseline, 42% of sufferers have been on a non-nucleoside reverse transcriptase inhibitor (NNRTI), 27% have been on protease inhibitors and 30% have been on an integrase strand switch inhibitor (INSTI) For every drug class, most sufferers within the NNRTI group have been on efavirenz, most within the protease inhibitor group have been on darunavir/ritonavir and most within the INSTI group have been on dolutegravir.
Moreover, when it comes to nucleoside reverse transcriptase inhibitor (NRTI) use, 66% of sufferers have been on tenofovir disoproxil fumarate (TDF), 19% have been on abacovir and seven% have been on tenofovir alafenamide (TAF) at baseline.
The imply weight change at follow-up was 1.31 kg, with outcomes demonstrating an affiliation between weight acquire better than 3 kg and the next:
- a routine containing TAF (HR = 2.526; 95% CI, 1.296-4.924);
- baseline prognosis of important hypertension (HR = 0.538; 95% CI, 0.311-0.928); and
- a routine containing an INSTI (HR = 1.581; 95% CI, 0.988-2.531).
In a separate evaluation, the researchers modeled imply weight adjustments accounting for variations in follow-up. They discovered that in each univariate and multivariate analyses, marijuana use, a darunavir-containing routine, white race and etravirine use have been related to weight reduction, whereas rilpivirine and bictagrivir use have been related to weight acquire. Notably, 33% of sufferers on rilpivirine have been additionally concurrently on TAF and total INSTI use was related to weight acquire.
“As patients with HIV are living longer on efficient ART, weight acquire must be monitored. Identification of threat components will turn out to be vital within the number of an antiretroviral routine,” Patel mentioned. “Key components for weight acquire in our clinic inhabitants included a baseline prognosis of hypertension, use of TAF and use of an integrase inhibitor. Sooner or later, we plan to check weight change over time with information collected on this research with the identical inhabitants after they change to an NRTI or an integrase inhibitor-based routine and/or a routine containing TAF.”