Real-world weight changes in people with HIV-1 at risk of weight gain (female, Black or Hispanic) switching from integrase strand transfer inhibitors

Abstract

Aim: Compare weight changes between people living with HIV-1 (PLWH) at high risk of weight gain (females, Blacks or Hispanics) switching from an integrase strand transfer inhibitor (INSTI) to a protease inhibitor (PI) or another INSTI. Materials & methods: Mean weight changes from pre-switch to up-to-12 months post-switch were retrospectively compared between PLWH switching to a PI or INSTI. Results: 356 PLWH were eligible. At 9- and 12-month post-switch, weight increases were observed for INSTI (weight: +1.55 kg and +1.59 kg), while decreases were observed for PI (-0.23 kg and -1.59 kg); differences between cohorts widened over time. Conclusion: These data suggest that switching off an INSTI may be a management tool to mitigate or reverse weight gain.

Weight and Metabolic Outcomes in Naïve HIV Patients Treated with Integrase Inhibitor-Based Antiretroviral Therapy: A Systematic Review and Meta-Analysis

“…Among female African American PWH who were naïve to antiretroviral therapy, the weight gain in 9.5 months of follow-up was 1.5 kg. with INSTIs [36], and in non-naïve PWH, the weight increase was 1.7 kg in females and 0.9 kg among African Americans [37]. However, in this population, switching from members of the INSTI family to members of the protease inhibitor family may reverse the weight gain > 6 months post-switch [37].…”

“…with INSTIs [36], and in non-naïve PWH, the weight increase was 1.7 kg in females and 0.9 kg among African Americans [37]. However, in this population, switching from members of the INSTI family to members of the protease inhibitor family may reverse the weight gain > 6 months post-switch [37]. With reference to lipid variations, we found a decrease in total cholesterol, LDL cholesterol, and triglycerides with the use of INSTIs in comparison to other families of antiretrovirals.…”