{"id":36647,"date":"2019-09-30T08:35:26","date_gmt":"2019-09-30T08:35:26","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=36647"},"modified":"2020-07-25T14:38:26","modified_gmt":"2020-07-25T14:38:26","slug":"greater-weight-gain-with-insti-based-than-non-insti-based-art-among-women-in-us-cohort","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/36647","title":{"rendered":"Greater weight gain with INSTI-based than non-INSTI-based ART among women in US cohort"},"content":{"rendered":"

Polly Clayden, HIV i-Base<\/strong><\/p>\n

Switch to an integrase strand transfer inhibitor (INSTI) was associated with significant increases in body weight, body circumferences, and fat percentages compared to non-INSTI ART in women in the Women\u2019s Interagency HIV Study (WIHS). [1]<\/strong><\/p>\n

There were no differences between observed changes in weight by INSTI(<\/strong>dolutegravir, elvitegravir, and raltegravir) but the numbers of women receiving each drug were quite small.<\/p>\n

WIHS is a large, US-based, prospective cohort study, started in 1993, designed to investigate the progression of HIV in women.<\/p>\n

Findings from the weight gain comparison were published in Clinical Infectious Diseases online 28 August 2019.<\/p>\n

In this study, women enrolled in WIHS from 2006\u20132017 who switched to or added an INSTI to their regimen were compared to women on non-INSTI ART.<\/p>\n

Body weight, body mass index (BMI), percentage body fat and waist, hip, arm, and thigh circumferences, were measured 6\u201312 months before and 6\u201318 months after INSTI switch\/add with similar time points for the women on non-INSTI ART.<\/p>\n

A total of 1118 women (234 INSTI and 884 non-INSTI) with a mean of two years follow up were included. The majority were African American (61%) their mean age was 49 years and weight at baseline was approximately 80 kg. There were no significant differences between the INSTI and non-INSTI groups.<\/p>\n

Of the INSTI group: 42% (97) switched\/added dolutegravir, 36% (85) raltegravir and 23% (52) elvitegravir.<\/p>\n

All analyses were adjusted for baseline age, race, WIHS site, education, income, smoking status, and baseline ART regimen.<\/p>\n

The INSTI group showed greater mean estimated increase compared with the non-INSTI group of 2.1 kg (2.4 vs 0.2 kg) in body weight (p<0.0001). The INSTI group had 0.8 kg\/m2 greater mean increase in BMI, (p<0.0001) and 1.4% greater mean increase in percentage body fat (p<0.01).<\/p>\n

There were also greater increases in waist, hip, arm, and thigh circumference in the INSTI group (all p <0.05).<\/p>\n

There were no differences in the extent of these of these increases by INSTI type and the investigators wrote that they suspect this is a class effect.<\/p>\n

comment<\/h3>\n

In this study, nearly one-fifth of women receiving INSTIs gained clinically significant body weight.<\/strong><\/p>\n

It was conducted among women with a mean age of almost 50 years. \u00a0During mid-life women gain approximately 0.7 kg per year and the investigators suggest that this may be compounded by additional 2 kg weight gain seen within 18 months in this study. <\/strong><\/p>\n

Women in the ADVANCE study (who were younger at a mean of 32 years at baseline) experienced the greatest mean increase in weight at 96 weeks (8 kg) when dolutegravir-based ART also included\u00a0 tenofovir alafenamide (TAF). [2]<\/strong><\/p>\n

In WIHS only 12% (29) women added TAF across all INSTI ART groups and the study did not look at differences by backbone antiretrovirals. <\/strong><\/p>\n

References<\/p>\n

    \n
  1. Kerchberger AM et al. Weight gain associated with integrase strand transfer inhibitor use in women. Clinical Infectious Diseases. Published online 28 August 2019.
    \nhttps:\/\/academic.oup.com\/cid\/advance-article\/doi\/10.1093\/cid\/ciz853\/5555884<\/a><\/li>\n
  2. Clayden P. Dolutegravir-based first-line non-inferior to efavirenz-based ART but associated with substantial weight gain: results from the ADVANCE study. HTB. 23 August 2019.
    \n    https:\/\/i-base.info\/htb\/36581<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Polly Clayden, HIV i-Base Switch to an integrase strand transfer inhibitor (INSTI) was associated with significant increases in body weight, body circumferences, and fat percentages compared to non-INSTI ART in women in the Women\u2019s Interagency HIV Study (WIHS). [1] There …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-36647","post","type-post","status-publish","format-standard","hentry","category-side-effects"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/36647","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=36647"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/36647\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=36647"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=36647"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=36647"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}