Skip to main content
Top
Published in: Infection 2/2020

01-04-2020 | Ritonavir | Original Paper

Weight gain in antiretroviral therapy-naive HIV-1-infected patients starting a regimen including an integrase strand transfer inhibitor or darunavir/ritonavir

Authors: Leonardo Calza, Vincenzo Colangeli, Marco Borderi, Isabella Bon, Aurora Borioni, Francesca Volpato, Maria Carla Re, Pierluigi Viale

Published in: Infection | Issue 2/2020

Login to get access

Abstract

Background

Weight gain after initiation of combination antiretroviral therapy (cART) is a possible side effect of all antiretroviral regimens, but it seems to be more evident in association with integrase strand transfer inhibitors (INSTIs). So, we aimed to evaluate weight change associated with an initial cART including one INSTI or darunavir–ritonavir (DRV/r).

Methods

A retrospective, observational, cohort study of antiretroviral therapy-naive adult HIV-positive patients starting an initial cART including raltegravir (RAL), dolutegravir (DTG), elvitegravir–cobicistat (EVG), or DRV/r. We compared changes in weight and body mass index (BMI) across the four groups during a 12-month follow-up.

Results

As a whole, 680 patients (470 males, mean age 42.1 years) were enrolled: 196 starting RAL, 174 DTG, 158 EVG/c, and 152 DRV/r. Baseline mean CD4 lymphocyte count was 455 cells/mm3 and 7.3% had an AIDS diagnosis. After 12 months, mean increase in body weight was 1.93 kg in the RAL group, 2.38 kg in the DTG group, 2.14 kg in the EVG group, and 1.85 in the DRV/r group. Mean increase in BMI was 0.71, 0.84, 0.77 and 0.63 kg/m2, respectively (p > 0.05 for each comparison). Therefore, no significant increases in weight and BMI were reported in each group, and no significant differences in weight and BMI changes were described across the four treatment groups.

Conclusions

In our study, patients starting an initial cART including one INSTI or DRV/r after 12 months showed a small and comparable, but not significant, increase in body weight, whose long-term clinical consequences are unknown.
Literature
1.
go back to reference Demir OM, Candilio L, Fuster D, Muga R, Barbaro G, Colombo A, et al. Cardiovascular disease burden among human immunodeficiency virus-infected individuals. Int J Cardiol. 2018;265:195–203.CrossRef Demir OM, Candilio L, Fuster D, Muga R, Barbaro G, Colombo A, et al. Cardiovascular disease burden among human immunodeficiency virus-infected individuals. Int J Cardiol. 2018;265:195–203.CrossRef
2.
go back to reference Sinha A, Feinstein MJ. Coronary artery disease manifestations in HIV: what, how, and why. Can J Cardiol. 2019;35:270–9.CrossRef Sinha A, Feinstein MJ. Coronary artery disease manifestations in HIV: what, how, and why. Can J Cardiol. 2019;35:270–9.CrossRef
3.
go back to reference Guaraldi G, Oralndo G, Zona S, Menozzi M, Carli F, Garlassi E, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. 2011;53:1120–6.CrossRef Guaraldi G, Oralndo G, Zona S, Menozzi M, Carli F, Garlassi E, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. 2011;53:1120–6.CrossRef
4.
go back to reference Rao SG, Galaviz KI, Gay HC, Wei J, Armstrong WS, del Rio C, et al. Factors associated with excess myocardial infarction risk in HIV-infected adults: a systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2019 Feb 20 [Epub ahead of print]. Rao SG, Galaviz KI, Gay HC, Wei J, Armstrong WS, del Rio C, et al. Factors associated with excess myocardial infarction risk in HIV-infected adults: a systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2019 Feb 20 [Epub ahead of print].
5.
go back to reference Lang S, Mary-Krause M, Cotte L, Gilquin J, Partisani M, Simon A, et al. French Hospital Database on HIV-ANRS CO4. Increased risk of myocardial infarction in HIV-infected patients in France, relative to the general population. AIDS. 2010;24:1228–30.CrossRef Lang S, Mary-Krause M, Cotte L, Gilquin J, Partisani M, Simon A, et al. French Hospital Database on HIV-ANRS CO4. Increased risk of myocardial infarction in HIV-infected patients in France, relative to the general population. AIDS. 2010;24:1228–30.CrossRef
6.
go back to reference Kumar S, Samaras K. The impact of weight gain during HIV treatment on risk of pre-diabetes, diabetes mellitus, cardiovascular disease, and mortality. Front Endocrinol (Lausanne). 2018;9:705.CrossRef Kumar S, Samaras K. The impact of weight gain during HIV treatment on risk of pre-diabetes, diabetes mellitus, cardiovascular disease, and mortality. Front Endocrinol (Lausanne). 2018;9:705.CrossRef
7.
go back to reference Herrin M, Tate JP, Akgün KM, Butt AA, Crothers K, Freiberg MS, et al. Weight gain and incident diabetes among HIV-infected veterans initiating antiretroviral therapy compared with uninfected individuals. J Acquir Immune Defic Syndr. 2016;73:228–36.CrossRef Herrin M, Tate JP, Akgün KM, Butt AA, Crothers K, Freiberg MS, et al. Weight gain and incident diabetes among HIV-infected veterans initiating antiretroviral therapy compared with uninfected individuals. J Acquir Immune Defic Syndr. 2016;73:228–36.CrossRef
8.
go back to reference Sattler FR, He J, Letendre S, Wilson C, Sanders C, Heaton R, et al. Abdominal obesity contributes to neurocognitive impairment in HIV-infected patients with increased inflammation and immune activation. J Acquir Immune Defic Syndr. 2015;68:281–8.CrossRef Sattler FR, He J, Letendre S, Wilson C, Sanders C, Heaton R, et al. Abdominal obesity contributes to neurocognitive impairment in HIV-infected patients with increased inflammation and immune activation. J Acquir Immune Defic Syndr. 2015;68:281–8.CrossRef
9.
go back to reference Bhagwat P, Ofotokun I, McComsey GA, Brown T, Moser C, Sugar CA, et al. Predictors of severe weight/body mass index gain following antiretroviral initiation. In: [Abstract 695] 24th Conference on Retroviruses and Opportunistic Infections (CROI) 13–16 February 2017. Bhagwat P, Ofotokun I, McComsey GA, Brown T, Moser C, Sugar CA, et al. Predictors of severe weight/body mass index gain following antiretroviral initiation. In: [Abstract 695] 24th Conference on Retroviruses and Opportunistic Infections (CROI) 13–16 February 2017.
10.
go back to reference Taramasso L, Ricci E, Menzaghi B, Orofino G, Passerini S, Madeddu G, et al. Weight gain: a possible effect of all antiretrovirals. Open Forum Infect Dis. 2017;4:ofx239.CrossRef Taramasso L, Ricci E, Menzaghi B, Orofino G, Passerini S, Madeddu G, et al. Weight gain: a possible effect of all antiretrovirals. Open Forum Infect Dis. 2017;4:ofx239.CrossRef
11.
go back to reference Lakey W, Yang LY, Yancy W, Chow SC, Hicks C. Short communication: from wasting to obesity: initial antiretroviral therapy and weight gain in HIV-infected persons. AIDS Res Hum Retrovir. 2013;29:435–40.CrossRef Lakey W, Yang LY, Yancy W, Chow SC, Hicks C. Short communication: from wasting to obesity: initial antiretroviral therapy and weight gain in HIV-infected persons. AIDS Res Hum Retrovir. 2013;29:435–40.CrossRef
12.
go back to reference Erlandson KM, Kitch D, Tierney C, Sax PE, Daar ES, Tebas P, et al. Weight and lean body mass change with antiretroviral initiation and impact on bone mineral density. AIDS. 2013;27:2069–79.CrossRef Erlandson KM, Kitch D, Tierney C, Sax PE, Daar ES, Tebas P, et al. Weight and lean body mass change with antiretroviral initiation and impact on bone mineral density. AIDS. 2013;27:2069–79.CrossRef
13.
go back to reference McComsey GA, Moser C, Currier J, Ribaudo HJ, Paczuski P, Dubé MP, et al. Body composition changes after initiation of raltegravir or protease inhibitors: actg A5260s. Clin Infect Dis. 2016;62:853–62.CrossRef McComsey GA, Moser C, Currier J, Ribaudo HJ, Paczuski P, Dubé MP, et al. Body composition changes after initiation of raltegravir or protease inhibitors: actg A5260s. Clin Infect Dis. 2016;62:853–62.CrossRef
14.
go back to reference Bourgi K, Jenkins C, Rebeiro PF, Lake JE, Moore RD, Mathews WC, et al. Greater weight gain among treatment-naïve persons starting integrase inhibitors. In: [Abstract 670] 26th Conference on Retroviruses and Opportunistic Infections (CROI) 4–7 March 2019. Bourgi K, Jenkins C, Rebeiro PF, Lake JE, Moore RD, Mathews WC, et al. Greater weight gain among treatment-naïve persons starting integrase inhibitors. In: [Abstract 670] 26th Conference on Retroviruses and Opportunistic Infections (CROI) 4–7 March 2019.
15.
go back to reference Menard A, Meddeb L, Tissot-Dupont H, Ravaux I, Dhiver C, Mokhtari S, et al. Dolutegravir and weight gain: an unexpected bothering side effect? AIDS. 2017;31:1499–500.CrossRef Menard A, Meddeb L, Tissot-Dupont H, Ravaux I, Dhiver C, Mokhtari S, et al. Dolutegravir and weight gain: an unexpected bothering side effect? AIDS. 2017;31:1499–500.CrossRef
16.
go back to reference Norwood J, Turner M, Bofill C, Rebeiro P, Shepherd B, Bebawy S, et al. Weight gain in persons with HIV switched from efavirenz-based to integrase strand transfer inhibitor-based regimens. J Acquir Immune Defic Syndr. 2017;76:527–31.CrossRef Norwood J, Turner M, Bofill C, Rebeiro P, Shepherd B, Bebawy S, et al. Weight gain in persons with HIV switched from efavirenz-based to integrase strand transfer inhibitor-based regimens. J Acquir Immune Defic Syndr. 2017;76:527–31.CrossRef
17.
go back to reference Kerchberger AM, Sheth AN, Angert CD, Mehta CC, Summers NA, Ofotokun I, et al. Integrase strand transfer inhibitors are associated with weight gain in women. In: [Abstract 672] 26th Conference on Retroviruses and Opportunistic Infections (CROI) 4–7 March 2019. Kerchberger AM, Sheth AN, Angert CD, Mehta CC, Summers NA, Ofotokun I, et al. Integrase strand transfer inhibitors are associated with weight gain in women. In: [Abstract 672] 26th Conference on Retroviruses and Opportunistic Infections (CROI) 4–7 March 2019.
18.
go back to reference Lake JE, Wu K, Erlandson KM, Bares SH, Debroy P, Godfrey C, et al. Risk factors for excess weight gain following switch to integrase inhibitor-based ART. In: [Abstract 669] 26th Conference on Retroviruses and Opportunistic Infections (CROI) 4–7 March 2019. Lake JE, Wu K, Erlandson KM, Bares SH, Debroy P, Godfrey C, et al. Risk factors for excess weight gain following switch to integrase inhibitor-based ART. In: [Abstract 669] 26th Conference on Retroviruses and Opportunistic Infections (CROI) 4–7 March 2019.
19.
go back to reference Bares SH, Smeaton LM, Xu A, Godfrey C, McComsey GA. HIV-infected women gain more weight than HIV-infected men following the initiation of antiretroviral therapy. J Womens Health (Larchmt). 2018;27:1162–9.CrossRef Bares SH, Smeaton LM, Xu A, Godfrey C, McComsey GA. HIV-infected women gain more weight than HIV-infected men following the initiation of antiretroviral therapy. J Womens Health (Larchmt). 2018;27:1162–9.CrossRef
20.
go back to reference Debroy P, Sim M, Erlandson KM, Falutz J, Prado CM, Brown TT, et al. Progressive increases in fat mass occur in adults living with HIV on antiretroviral therapy, but patterns differ by sex and anatomic depot. J Antimicrob Chemother. 2019;74:1028–34.CrossRef Debroy P, Sim M, Erlandson KM, Falutz J, Prado CM, Brown TT, et al. Progressive increases in fat mass occur in adults living with HIV on antiretroviral therapy, but patterns differ by sex and anatomic depot. J Antimicrob Chemother. 2019;74:1028–34.CrossRef
21.
go back to reference Gomez M, Seybold U, Roider J, Harter G, Bogner JR. A retrospective analysis of weight changes in HIV-positive patients switching from a tenofovir disoproxil fumarate (TDF)- to a tenofovir alafenamide fumarate (TAF)-containing treatment regimen in one German university hospital in 2015-2017. Infection. 2019;47:95–102.CrossRef Gomez M, Seybold U, Roider J, Harter G, Bogner JR. A retrospective analysis of weight changes in HIV-positive patients switching from a tenofovir disoproxil fumarate (TDF)- to a tenofovir alafenamide fumarate (TAF)-containing treatment regimen in one German university hospital in 2015-2017. Infection. 2019;47:95–102.CrossRef
22.
go back to reference Kouanfack C, Mpoudi-Etame M, Omgba Bassega P, Eymard-Duvernay S, Leroy S, Boyer S, NAMSAL ANRS 12313 Study Group, et al. Dolutegravir-based or low-dose efavirenz-based regimen for the treatment of HIV-1. N Engl J Med. 2019;381:816–26.CrossRef Kouanfack C, Mpoudi-Etame M, Omgba Bassega P, Eymard-Duvernay S, Leroy S, Boyer S, NAMSAL ANRS 12313 Study Group, et al. Dolutegravir-based or low-dose efavirenz-based regimen for the treatment of HIV-1. N Engl J Med. 2019;381:816–26.CrossRef
23.
go back to reference Venter WD, Moorhouse M, Sokhela S, Fairlie L, Mashabane N, Masenya M, et al. Dolutegravir plus two different prodrugs of tenofovir to treat HIV. N Engl J Med. 2019;381:803–15.CrossRef Venter WD, Moorhouse M, Sokhela S, Fairlie L, Mashabane N, Masenya M, et al. Dolutegravir plus two different prodrugs of tenofovir to treat HIV. N Engl J Med. 2019;381:803–15.CrossRef
24.
go back to reference Achhra AC, Mocroft A, Reiss P, Sabin C, Ryom L, de Wit S, et al. Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study. HIV Med. 2016;17:255–68.CrossRef Achhra AC, Mocroft A, Reiss P, Sabin C, Ryom L, de Wit S, et al. Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study. HIV Med. 2016;17:255–68.CrossRef
25.
go back to reference Yuh B, Tate J, Butt AA, Crothers K, Freiberg M, Leaf D, et al. Weight change after antiretroviral therapy and mortality. Clin Infect Dis. 2015;60:1852–9.CrossRef Yuh B, Tate J, Butt AA, Crothers K, Freiberg M, Leaf D, et al. Weight change after antiretroviral therapy and mortality. Clin Infect Dis. 2015;60:1852–9.CrossRef
Metadata
Title
Weight gain in antiretroviral therapy-naive HIV-1-infected patients starting a regimen including an integrase strand transfer inhibitor or darunavir/ritonavir
Authors
Leonardo Calza
Vincenzo Colangeli
Marco Borderi
Isabella Bon
Aurora Borioni
Francesca Volpato
Maria Carla Re
Pierluigi Viale
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 2/2020
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-019-01376-5

Other articles of this Issue 2/2020

Infection 2/2020 Go to the issue