Risk of metabolic syndrome when starting ART with bictegravir vs dolutegravir
7 June 2025. Related: Journal scan, Side effects, Weight, diabetes, metabolic complications.
Simon Collins, HIV i-Base
This randomised, open-label study reported the incidence of developing metabolic syndrome (MS) by 48 weeks in 278 people starting their first ART with second-generation INSTIs.
The incidence of MS was 6 (3.9%) vs 10 (6.3%) in participants starting with BIC/TAF/FTC vs DTG/ABC/3TC arms, respectively, with no significant difference between groups. In the BIC/TAF/FTC group, 24 participants (9%) experienced a weight gain of ≥10% vs 16 participants (6%) in the BIC/TAF/FTC vs DTG/ABC/3TC arms, respectively, (p = 0.72).
Risk factors for MS were age ≥40 years, baseline BMI ≥25 kg/m2, and baseline visceral fat ≥5 cm prior to ART initiation.
Reference
Marin M et al. Incidence of Metabolic syndrome in people with HIV without experienCe to antiretroviral Therapy who start doLutegravir based-regimen compared with bictegrAvir based-regimeN after 48 weeks (MICTLAN trial). AIDS ():10.1097/QAD.0000000000004259. (5 June 2025).
https://journals.lww.com/aidsonline/abstract/9900/incidence_of_metabolic_syndrome_in_people_with_hiv.726.aspx