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. 2020 May 26;7(6):ofaa195.
doi: 10.1093/ofid/ofaa195. eCollection 2020 Jun.

Factors Associated With Weight Gain in People Treated With Dolutegravir

Lucia Taramasso  1   2 , Paolo Bonfanti  3 , Elena Ricci  4 , Giancarlo Orofino  5 , Nicola Squillace  6 , Barbara Menzaghi  7 , Giuseppe Vittorio De Socio  8 , Giordano Madeddu  9 , Giovanni Francesco Pellicanò  10 , Layla Pagnucco  11 , Benedetto Maurizio Celesia  12 , Leonardo Calza  13 , Federico Conti  14 , Canio Vito Martinelli  15 , Laura Valsecchi  16 , Antonio Cascio  17 , Cesare Bolla  18 , Paolo Maggi  19 , Francesca Vichi  20 , Chiara Dentone  21 , Goffredo Angioni  22 , Antonio Mastroianni  23 , Katia Falasca  24 , Giovanni Cenderello  21   25 , Antonio Di Biagio  26
Affiliations

Factors Associated With Weight Gain in People Treated With Dolutegravir

Lucia Taramasso et al. Open Forum Infect Dis. .

Abstract

Background: An unexpected excess in weight gain has recently been reported in the course of dolutegravir (DTG) treatment. The aim of the present study was to investigate whether weight gain differs among different DTG-containing regimens.

Methods: Adult naïve and experienced people with HIV (PWH) initiating DTG-based antiretroviral therapy (ART) between July 2014 and December 2019 in the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) prospective cohort were included. We used an adjusted general linear model to compare weight change among backbone groups and a Cox proportional hazard regression model to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for weight increases >10% from baseline.

Results: A total of 713 participants, 25.3% women and 91% Caucasian, were included. Of these, 195 (27.4%) started DTG as their first ART regimen, whereas 518 (72.6%) were ART-experienced. DTG was associated with abacavir/lamivudine in 326 participants, tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in 148, boosted protease inhibitors in 60, rilpivirine in 45, lamivudine in 75, and tenofovir alafenamide (TAF)/FTC in 59. At 6 and 12 months, weight gain was highest among PWH on TDF/FTC+DTG and TAF/FTC+DTG. Baseline CD4 <200 cells/mm3 (HR, 1.84; 95% CI, 1.15 to 2.96), being ART-naïve (HR, 2.24; 95% CI, 1.24 to 4.18), and treatment with TDF/FTC+DTG (HR, 1.92; 95% CI, 1.23 to 2.98) or TAF/FTC+DTG (HR, 3.80; 95% CI, 1.75 to 8.23) were associated with weight gain >10% from baseline. Higher weight (HR, 0.97 by 1 kg; 95% CI, 0.96 to 0.99) and female gender (HR, 0.54; 95% CI, 0.33 to 0.88) were protective against weight gain.

Conclusions: Naïve PWH with lower CD4 counts and those on TAF/FTC or TDF/FTC backbones were at higher risk of weight increase in the course of DTG-based ART.

Keywords: HIV metabolic complications; TAF; TDF; dolutegravir; weight gain.

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Figures

Figure 1.
Figure 1.
Weight by regimen. Mean weight (kg) at baseline and 6-month, 12-month, 18-month, and 24-month follow-up in people treated with different dolutegravir-containing regimens. Dolutegravir was associated with abacavir/lamivudine in 326 participants, tenofovir disoproxil fumarate/emtricitabine in 148, boosted protease inhibitors in 60, rilpivirine in 45, lamivudine in 75, and tenofovir alafenamide/emtricitabine in 59. Abbreviations: 3TC, lamivudine; ABC, abacavir; DTG, dolutegravir; FTC, emtricitabine; PI, protease inhibitor; RPV, rilpivirine; TDF, tenofovir disoproxil fumarate; TAF, tenofovir alafenamide.
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