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. 2023 Mar;24(3):301-310.
doi: 10.1111/hiv.13388. Epub 2022 Sep 5.

Real-world experience with weight gain among pregnant women living with HIV who are using integrase inhibitors

Trevon Fuller  1   2 , Maria Isabel Fragoso da Silveira Gouvêa  1   3 , Maria de Lourdes Benamor Teixeira  1   3 , Adriana Ferreira Medeiros  1 , Patricia Amorim da Silva  4 , Camile Medeiros Braga  1 , Miriam Constan Werneck Sant'anna  4 , Mariza de Mattos Salgueiro  1 , Clarisse da Silveira Bressan  1   3 , Wallace Mendes-Silva  4 , Esau C João  1
Affiliations

Real-world experience with weight gain among pregnant women living with HIV who are using integrase inhibitors

Trevon Fuller et al. HIV Med. 2023 Mar.

Abstract

Objectives: We assessed real-world weight change and pregnancy outcomes among pregnant women living with HIV who used integrase strand transferase inhibitor (INSTI)-based combined antiretroviral therapy (cART).

Methods: In a retrospective cohort study from 2014 to 2021 for prevention of perinatal HIV infection, we evaluated changes in weight from the first prenatal visit to near delivery for two groups. The categories of change were: low (< 0.18 kg/week), normal (0.18-0.59 kg/week), and high (> 0.59 kg/week). The backbones were lamivudine + tenofovir disoproxil or lamivudine + zidovudine. The comparison groups were women with body mass index (BMI) < 25 kg/m2 versus BMI ≥ 25 kg/m2 and INSTI-naïve versus INSTI-experienced. Continuous variables were analysed with a Kruskal-Wallis test and count or categorical data with χ2 tests.

Results: We enrolled 198 pregnant women. At study entry, 74 had BMI < 25 kg/m2 and 124 had BMI ≥ 25 kg/m2 . Excess gestational weight gain was more frequent among women who were INSTI-naïve among both BMI groups (< 25 and ≥ 25). However, the proportion of participants per weight change category was only significantly different between INSTI-naïve women with baseline BMI < 25 kg/m2 and INSTI-experienced women with BMI < 25 kg/m2 . In particular, INSTI-naïve women with BMI < 25 kg/m2 had significantly higher rates of excess gestational weight gain (31.6%) compared with participants with BMI < 25 kg/m2 who conceived while on INSTIs (11.8%, p = 0.004). Rates of unfavourable pregnancy outcomes were low and did not differ significantly between groups.

Conclusions: INSTI-naïve participants with BMI < 25 kg/m2 gained more weight during pregnancy than participants with BMI ≥ 25 kg/m2 who conceived while using INSTIs. Rates of adverse pregnancy outcomes did not differ between the groups.

Keywords: HIV integrase inhibitors; anti-HIV agents; gestational weight gain; pregnancy outcomes.

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Conflict of interest statement

Conflict of interests disclosure: The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow chart of participants enrolled in the weight gain analysis (n = 198 final participants).
Figure 2.
Figure 2.
Duration of INSTI use by treatment-experience and BMI (body mass index).
Figure 3.
Figure 3.
Weight change among pregnant women living with HIV in use of INSTI, 2014–2021 (N=199). Percent of naive and experienced participants by weight change category and baseline BMI. The categories of change were: low (< 0.18 kg/week), normal (0.18–0.59 kg/week), and high (>0.59 kg/week).
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