Determining Weight Gain on ART Therapy

Initiation of ART therapy is associated with weight gain, and with it come concerns related to this side effect.

In a study presented virtually at IDWeek, investigators wanted to study the factors associated with massive weight gain as well as to assess if early weight gain could help predict massive weight gain at two years.

This study was retrospective looking at PWH initiating ART therapy from January 2005 through March 2019, and who follow-up interactions 21 to 27 months without ART changes, and were suppressed (HIV-RNA < 200 cps/ml) during that time.

The investigators defined massive weight gain as the top 20% of weight gainers at two years measured by percent gained compared to baseline. “Using bivariate and multivariate logistic regression (including factors in bivariate analysis with p< 0.20), we assessed the association of demographics, ART regimen, baseline CD4 count, HIV viral load, and body mass index (BMI) with weight gain at 2 years,” the investigators wrote. “We also assessed early weight gain (between 4 and 12 wks) and its association with massive weight gain at two years.”

Of 266 PWH included in the study, 36 years was the median age and 9% were women, 14% black, and 43% Latino. The median weight gain at 2 years was 4% (-1.1 – 11.6), “In bivariate analyses, baseline factors significantly associated with massive weight gain included lower CD4 count, higher viral load, and lower baseline BMI.”

In terms of ART itself the therapies were not associated with weight gain. “In this real-world dataset, drug class or specific NRTI use was not associated with massive weight gain which was primarily dependent on baseline CD4 count and HIV viral load.”

The investigators noted there are opportunities for earlier interventions to help with avoiding weight gain. “There was a moderate correlation between early weight gain and massive weight gain at 2 years which can help with patient counseling and interventions aimed at slowing weight gain in this population,” the investigators reported.

The study, “Massive Weight Gain in People with HIV (PWH) Starting Initial Antiretroviral Therapy (ART): Risk Factors and Predictive Ability of Early Weight Gain,” was presented virtually at IDWeek 2021, held September 29-October 3, 2021.