{"id":44145,"date":"2022-10-03T07:38:56","date_gmt":"2022-10-03T07:38:56","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=44145"},"modified":"2022-10-08T20:28:05","modified_gmt":"2022-10-08T20:28:05","slug":"aids-2022-gender-affirming-hormones-weight-gain-and-art","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/44145","title":{"rendered":"AIDS 2022: Gender-affirming hormones, weight gain and ART"},"content":{"rendered":"

Kirk Taylor, HIV i-Base<\/strong><\/p>\n

\"\"An overview on gender-affirming hormone therapy, weight gain and ART presented by Emilia Jalil from FIOCRUZ, Brazil, included a report that trans women (TW) gain more weight on INSTI or TAF-based regimens than trans men (TM). \u00a0[1] <\/strong><\/p>\n

This is important as transgender people have disproportionate risk of becoming HIV positive and are considered a priority group for prevention and care strategies. ART studies tend to recruit low numbers of trans participants and lack disaggregated trans data.<\/p>\n

Approximately 50% of transgender people take gender-affirming hormones, with a further 30% having considered hormone therapy. TW receive anti-androgen plus oestrogen therapies that cause physical changes (ie reduced muscle mass and body fat redistribution), and favourable lipid profile changes.<\/p>\n

Testosterone therapy for TM drives development of masculine secondary characteristics. Testosterone increases muscle mass, redistributes body fat, and worsens lipid profiles (raising LDL, cholesterol and triglycerides and lowering HDL).<\/p>\n

Weight gain is associated with gender affirming hormones with increases seen within 4 months for TM and after 22 months for TW. TM report higher rates of obesity and weight gain.<\/p>\n

Although many HIV drugs do not interact with hormone therapy, it is important to be aware of drug-drug interactions with some drugs and to consider potential adverse effects. Doctors need to understand these data in order to reduce the risk of altered adherence by trans people. [2]<\/p>\n

The ADVANCE study reported weight gain in trans people using three commonly-used first-line combinations. \u00a0At week-144, weight gain occurred with all regimens with the greatest increases observed for TW: TAF\/FTC\/DTG (+12.3 kg for TW vs +7.2 kg for TM) >TDF\/FTC\/DTG (+7.4 kg for TW vs +5.5 kg for TM) >TDF\/FTC\/EFV (+5.5 kg for TW vs +2.6 kg for TM). [3]<\/p>\n

Although CAB-LA injections were not associated with weight gain in HIV negative participants in the HPTN 077 PrEP study, when used as treatment, injectable CAB-LA\/RPV-LA in people living with HIV, weight increases were similar to dolutegravir-based ART. [4, 5]<\/p>\n

More work is required to overcome knowledge gaps due to trials not enrolling enough trans people and\/or lack of trans-specific analyses.<\/p>\n

comment<\/h3>\n

Liverpool University publish a comprehensive resource on potential drug interactions between ART and hormone treatment which is also updated id new data become available. [2]<\/strong><\/p>\n

References<\/p>\n

    \n
  1. Jalil EM. Hormones, trans populations, and metabolic consequences. Metabolic consequences of new classes of ART. AIDS 2022 (Montreal). 29 July to 2\u00a0August 2022.
    \nprogramme.aids2022.org\/Programme\/Session\/23<\/a><\/li>\n
  2. Liverpool University Drug Interaction Website. Hormone therapy for gender transitioning, (February 2019 update).
    \nhttps:\/\/liverpool-hiv-hep.s3.amazonaws.com\/prescribing_resources\/pdfs\/000\/000\/007\/original\/Hormone_Chart_2019_Feb.pdf<\/li>\n
  3. Sokhela SM. The ADVANCE trial: Phase 3, randomised comparison of TAF\/FTC+DTG, TDF\/FTC+DTG or TDF\/FTC\/EFV for first-line treatment of HIV-1 infection. AIDS 2020 (Virtual). 6 to 10 July 2020.
    \n    programme.aids2020.org\/Abstract\/Abstract\/10954<\/a>\u00a0(abstract)
    \n    programme.aids2020.org\/Programme\/Session\/44<\/a> (webcast)<\/li>\n
  4. Landovitz RJ et al. Cabotegravir Is Not Associated With Weight Gain in Human Immunodeficiency Virus-uninfected Individuals in HPTN 077. Clin Infect Dis. 2020 Jan 2;70(2):319-322. doi: 10.1093\/cid\/ciz439.<\/li>\n
  5. Taylor K. Long-acting CAB\/RPV injections have a similar weight and lipid profile to dolutegravir-based oral ART. HTB (1 September 2022).
    \n    i-base.info\/htb\/43782<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Kirk Taylor, HIV i-Base An overview on gender-affirming hormone therapy, weight gain and ART presented by Emilia Jalil from FIOCRUZ, Brazil, included a report that trans women (TW) gain more weight on INSTI or TAF-based regimens than trans men (TM). …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,34,8],"tags":[320],"class_list":["post-44145","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-pk-and-drug-interactions","category-side-effects","tag-world-aids-24-montreal-2022"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/44145","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=44145"}],"version-history":[{"count":7,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/44145\/revisions"}],"predecessor-version":[{"id":44202,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/44145\/revisions\/44202"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=44145"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=44145"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=44145"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}