TY - JOUR
T1 - Weight gain associated with integrase stand transfer inhibitor use in women
AU - Kerchberger, Anne Marie
AU - Sheth, Anandi N.
AU - Angert, Christine D.
AU - Mehta, C. Christina
AU - Summers, Nathan A.
AU - Ofotokun, Ighovwerha
AU - Gustafson, Deborah
AU - Weiser, Sheri D.
AU - Sharma, Anjali
AU - Adimora, Adaora A.
AU - French, Audrey L.
AU - Augenbraun, Michael
AU - Cocohoba, Jennifer
AU - Kassaye, Seble
AU - Bolivar, Hector
AU - Govindarajulu, Usha
AU - Konkle-Parker, Deborah
AU - Golub, Elizabeth T.
AU - Lahiri, Cecile D.
N1 - Funding Information:
Potential conflicts of interest. A. N. S. received grant funding from Gilead. N. A. S. received grant funding from the National Center for Advancing Translational Sciences of the National Institutes of Health. A. A. A. received personal fees from Merck, Gilead, and Viiv and grants from Gilead. H. B. received grants from Glaxo Smith Klein. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
Funding Information:
Financial support. This work was supported by the Women’s Interagency Human Immunodeficiency Virus Study (WIHS), via the UAB-MS WIHS (grant number U01-AI-103401), Atlanta WIHS (grant number U01-AI-103408), Bronx WIHS (grant number U01-AI-035004), Brooklyn WIHS (grant number U01-AI-031834), Chicago WIHS (grant number U01-AI-034993), Metropolitan Washington WIHS (grant number U01-AI-034994), Miami WIHS (grant number U01-AI-103397), University of North Carolina WIHS (grant number U01-AI-103390), Connie Wofsy Women’s Human Immunodeficiency Virus Study, Northern California (grant number U01-AI-034989) WIHS Data Management and Analysis Center (grant number U01-AI-042590), Southern California WIHS (grant number U01-HD-032632; WIHS I – WIHS IV), University of California at San Francisco Clinical and Translational Science Award (CTSA) (grant number UL1-TR000004), Atlanta CTSA (grant number UL1-TR000454), University of North Carolina Center for AIDS Research (CFAR) (grant number P30-AI-050410), and UAB CFAR (grant number P30-AI-027767). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute on Mental Health. Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Deafness and Other Communication Disorders, and the National Institutes of Health Office of Research on Women’s Health. This work was also supported by grant number K23 AI114407 to A. N. S. funded by the NIH, National Institute of Allergy and Infectious Diseases (NIAID); grant number K23 AI124913 funded by the NIH, NIAID to C. D. L.; grant number K23 AR061993 to A. S. funded by NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); grant numbers UL1 TR002378 and TL1 TR002382 to N. A. S. funded by NIH/National Center for Advancing Translational Science (NCATS); grant number R01 MH095683 to S. D. W. funded by NIH/National Institute of Mental Health (NIMH); and Emory CFAR (grant number P30AI050409).
Publisher Copyright:
© The Author(s) 2019.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Background. Integrase strand-transfer inhibitor (INSTI)-based antiretroviral therapy (ART) is recommended for human immunodeficiency virus (HIV) management. Although studies have suggested associations between INSTIs and weight gain, women living with HIV (WLHIV) have been underrepresented in research. We evaluated the effect of switching or adding INSTIs among WLHIV. Methods. Women enrolled in the Women's Interagency HIV Study (WIHS) from 2006-2017 who switched to or added an INSTI to ART (SWAD group) were compared to women on non-INSTI ART (STAY group). Body weight, body mass index (BMI), percentage body fat (PBF), and waist, hip, arm, and thigh circumferences were measured 6-12 months before and 6-18 months after the INSTI switch/add in SWAD participants, with comparable measurement time points in STAY participants. Linear regression models compared changes over time by SWAD/STAY group, adjusted for age, race, WIHS site, education, income, smoking status, and baseline ART regimen. Results. We followed 1118 women (234 SWAD and 884 STAY) for a mean of 2.0 years (+/- 0.1 standard deviation [SD]; mean age 48.8 years, SD +/- 8.8); 61% were Black. On average, compared to the STAY group, the SWAD group experienced mean greater increases of 2.1 kg in body weight, 0.8 kg/m2 in BMI, 1.4% in PBF, and 2.0, 1.9, 0.6, and 1.0 cm in waist, hip, arm, and thigh circumference, respectively (all P values < .05). No differences in magnitudes of these changes were observed by INSTI type. Conclusions. In WLHIV, a switch to INSTI was associated with significant increases in body weight, body circumferences, and fat percentages, compared to non-INSTI ART. The metabolic and other health effects of these changes deserve further investigation.
AB - Background. Integrase strand-transfer inhibitor (INSTI)-based antiretroviral therapy (ART) is recommended for human immunodeficiency virus (HIV) management. Although studies have suggested associations between INSTIs and weight gain, women living with HIV (WLHIV) have been underrepresented in research. We evaluated the effect of switching or adding INSTIs among WLHIV. Methods. Women enrolled in the Women's Interagency HIV Study (WIHS) from 2006-2017 who switched to or added an INSTI to ART (SWAD group) were compared to women on non-INSTI ART (STAY group). Body weight, body mass index (BMI), percentage body fat (PBF), and waist, hip, arm, and thigh circumferences were measured 6-12 months before and 6-18 months after the INSTI switch/add in SWAD participants, with comparable measurement time points in STAY participants. Linear regression models compared changes over time by SWAD/STAY group, adjusted for age, race, WIHS site, education, income, smoking status, and baseline ART regimen. Results. We followed 1118 women (234 SWAD and 884 STAY) for a mean of 2.0 years (+/- 0.1 standard deviation [SD]; mean age 48.8 years, SD +/- 8.8); 61% were Black. On average, compared to the STAY group, the SWAD group experienced mean greater increases of 2.1 kg in body weight, 0.8 kg/m2 in BMI, 1.4% in PBF, and 2.0, 1.9, 0.6, and 1.0 cm in waist, hip, arm, and thigh circumference, respectively (all P values < .05). No differences in magnitudes of these changes were observed by INSTI type. Conclusions. In WLHIV, a switch to INSTI was associated with significant increases in body weight, body circumferences, and fat percentages, compared to non-INSTI ART. The metabolic and other health effects of these changes deserve further investigation.
KW - HIV positive
KW - Integrase strand transfer inhibitors
KW - Weight gain
KW - Women
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U2 - 10.1093/cid/ciz853
DO - 10.1093/cid/ciz853
M3 - Article
C2 - 31504324
AN - SCOPUS:85088849479
VL - 71
SP - 593
EP - 600
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 3
ER -