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Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada

INTRODUCTION: Weight gain following antiretroviral therapy (ART) initiation is common, potentially predisposing some persons with HIV (PWH) to cardio‐metabolic disease. We assessed relationships between ART drug class and weight change among treatment‐naïve PWH initiating ART in the North American A...

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Autores principales: Bourgi, Kassem, Jenkins, Cathy A, Rebeiro, Peter F, Palella, Frank, Moore, Richard D, Altoff, Keri N, Gill, John, Rabkin, Charles S, Gange, Stephen J, Horberg, Michael A, Margolick, Joseph, Li, Jun, Wong, Cherise, Willig, Amanda, Lima, Viviane D, Crane, Heidi, Thorne, Jennifer, Silverberg, Michael, Kirk, Gregory, Mathews, William C, Sterling, Timothy R, Lake, Jordan, Koethe, John R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159248/
https://www.ncbi.nlm.nih.gov/pubmed/32294337
http://dx.doi.org/10.1002/jia2.25484
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author Bourgi, Kassem
Jenkins, Cathy A
Rebeiro, Peter F
Palella, Frank
Moore, Richard D
Altoff, Keri N
Gill, John
Rabkin, Charles S
Gange, Stephen J
Horberg, Michael A
Margolick, Joseph
Li, Jun
Wong, Cherise
Willig, Amanda
Lima, Viviane D
Crane, Heidi
Thorne, Jennifer
Silverberg, Michael
Kirk, Gregory
Mathews, William C
Sterling, Timothy R
Lake, Jordan
Koethe, John R
author_facet Bourgi, Kassem
Jenkins, Cathy A
Rebeiro, Peter F
Palella, Frank
Moore, Richard D
Altoff, Keri N
Gill, John
Rabkin, Charles S
Gange, Stephen J
Horberg, Michael A
Margolick, Joseph
Li, Jun
Wong, Cherise
Willig, Amanda
Lima, Viviane D
Crane, Heidi
Thorne, Jennifer
Silverberg, Michael
Kirk, Gregory
Mathews, William C
Sterling, Timothy R
Lake, Jordan
Koethe, John R
author_sort Bourgi, Kassem
collection PubMed
description INTRODUCTION: Weight gain following antiretroviral therapy (ART) initiation is common, potentially predisposing some persons with HIV (PWH) to cardio‐metabolic disease. We assessed relationships between ART drug class and weight change among treatment‐naïve PWH initiating ART in the North American AIDS Cohort Collaboration on Research and Design (NA‐ACCORD). METHODS: Adult, treatment‐naïve PWH in NA‐ACCORD initiating integrase strand transfer inhibitor (INSTI), protease inhibitor (PI) or non‐nucleoside reverse‐transcriptase inhibitor (NNRTI)‐based ART on/after 1 January 2007 were followed through 31 December 2016. Multivariate linear mixed effects models estimated weight up to five years after ART initiation, adjusting for age, sex, race, cohort site, HIV acquisition mode, treatment year, and baseline weight, plasma HIV‐1 RNA level and CD4(+) cell count. Due to shorter follow‐up for PWH receiving newer INSTI drugs, weights for specific INSTIs were estimated at two years. Secondary analyses using logistic regression and all covariates from primary analyses assessed factors associated with >10% weight gain at two and five years. RESULTS: Among 22,972 participants, 87% were male, and 41% were white. 49% started NNRTI‐, 31% started PI‐ and 20% started INSTI‐based regimens (1624 raltegravir (RAL), 2085 elvitegravir (EVG) and 929 dolutegravir (DTG)). PWH starting INSTI‐based regimens had mean estimated five‐year weight change of +5.9kg, compared to +3.7kg for NNRTI and +5.5kg for PI. Among PWH starting INSTI drugs, mean estimated two‐year weight change was +7.2kg for DTG, +5.8kg for RAL and +4.1kg for EVG. Women, persons with lower baseline CD4(+) cell counts, and those initiating INSTI‐based regimens had higher odds of >10% body weight increase at two years (adjusted odds ratio = 1.37, 95% confidence interval: 1.20 to 1.56 vs. NNRTI). CONCLUSIONS: PWH initiating INSTI‐based regimens gained, on average, more weight compared to NNRTI‐based regimens. This phenomenon may reflect heterogeneous effects of ART agents on body weight regulation that require further exploration.
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spelling pubmed-71592482020-04-20 Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada Bourgi, Kassem Jenkins, Cathy A Rebeiro, Peter F Palella, Frank Moore, Richard D Altoff, Keri N Gill, John Rabkin, Charles S Gange, Stephen J Horberg, Michael A Margolick, Joseph Li, Jun Wong, Cherise Willig, Amanda Lima, Viviane D Crane, Heidi Thorne, Jennifer Silverberg, Michael Kirk, Gregory Mathews, William C Sterling, Timothy R Lake, Jordan Koethe, John R J Int AIDS Soc Research Articles INTRODUCTION: Weight gain following antiretroviral therapy (ART) initiation is common, potentially predisposing some persons with HIV (PWH) to cardio‐metabolic disease. We assessed relationships between ART drug class and weight change among treatment‐naïve PWH initiating ART in the North American AIDS Cohort Collaboration on Research and Design (NA‐ACCORD). METHODS: Adult, treatment‐naïve PWH in NA‐ACCORD initiating integrase strand transfer inhibitor (INSTI), protease inhibitor (PI) or non‐nucleoside reverse‐transcriptase inhibitor (NNRTI)‐based ART on/after 1 January 2007 were followed through 31 December 2016. Multivariate linear mixed effects models estimated weight up to five years after ART initiation, adjusting for age, sex, race, cohort site, HIV acquisition mode, treatment year, and baseline weight, plasma HIV‐1 RNA level and CD4(+) cell count. Due to shorter follow‐up for PWH receiving newer INSTI drugs, weights for specific INSTIs were estimated at two years. Secondary analyses using logistic regression and all covariates from primary analyses assessed factors associated with >10% weight gain at two and five years. RESULTS: Among 22,972 participants, 87% were male, and 41% were white. 49% started NNRTI‐, 31% started PI‐ and 20% started INSTI‐based regimens (1624 raltegravir (RAL), 2085 elvitegravir (EVG) and 929 dolutegravir (DTG)). PWH starting INSTI‐based regimens had mean estimated five‐year weight change of +5.9kg, compared to +3.7kg for NNRTI and +5.5kg for PI. Among PWH starting INSTI drugs, mean estimated two‐year weight change was +7.2kg for DTG, +5.8kg for RAL and +4.1kg for EVG. Women, persons with lower baseline CD4(+) cell counts, and those initiating INSTI‐based regimens had higher odds of >10% body weight increase at two years (adjusted odds ratio = 1.37, 95% confidence interval: 1.20 to 1.56 vs. NNRTI). CONCLUSIONS: PWH initiating INSTI‐based regimens gained, on average, more weight compared to NNRTI‐based regimens. This phenomenon may reflect heterogeneous effects of ART agents on body weight regulation that require further exploration. John Wiley and Sons Inc. 2020-04-15 /pmc/articles/PMC7159248/ /pubmed/32294337 http://dx.doi.org/10.1002/jia2.25484 Text en © 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Bourgi, Kassem
Jenkins, Cathy A
Rebeiro, Peter F
Palella, Frank
Moore, Richard D
Altoff, Keri N
Gill, John
Rabkin, Charles S
Gange, Stephen J
Horberg, Michael A
Margolick, Joseph
Li, Jun
Wong, Cherise
Willig, Amanda
Lima, Viviane D
Crane, Heidi
Thorne, Jennifer
Silverberg, Michael
Kirk, Gregory
Mathews, William C
Sterling, Timothy R
Lake, Jordan
Koethe, John R
Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada
title Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada
title_full Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada
title_fullStr Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada
title_full_unstemmed Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada
title_short Weight gain among treatment‐naïve persons with HIV starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada
title_sort weight gain among treatment‐naïve persons with hiv starting integrase inhibitors compared to non‐nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the united states and canada
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159248/
https://www.ncbi.nlm.nih.gov/pubmed/32294337
http://dx.doi.org/10.1002/jia2.25484
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