Study Highlights Link Between ART and Weight Gain in Virally Suppressed Participants

A study reports that weight gain in individuals on ART was associated with lower BMI, reduced proportion of hypogonadism, increased proportion of psychiatric disorders, and non-PI-containing regimens.

Weight gain is commonly referenced as a complication of HIV treatment, yet little is known about the connection between antiretroviral treatment (ART) and increased body weight.

To learn more about the association between the 2, a team of investigations set out to identify variables independently associated with metabolic changes. The findings of the study were presented in a poster presentation at the Annual Conference on Retroviruses and Opportunistic Infections (CROI 2019) on Wednesday, March 6, 2019.

Another primary objective of the research was to describe the demographic, clinical, and treatment characteristics of adults with virally suppressed HIV that had ≥3% annual weight gain between 2013 and 2018.

The investigators compiled electronic medical records and prescription data for the most recent ART for 3468 previously-treated adult patients with continued HIV suppression from 21 states and Washington, DC, who were in care at 6 HIV treatment centers. The observation window was August 2013 to August 2018 and represented 5459 patient years.

Study inclusion required ≥1 BMI at antiretroviral prescription and ≥1 BMI between 1 and 2 years of treatment

Bivariate comparisons were made using chi-square, or Fisher’s tests, followed by independent variable assessment via logistic regression.

The study found that among the 3468 adults, annualized weight gain was ≥3% for 1045 (30%) participants.

Compared with those with fewer than 3% weight gain, the investigators found that the group with >3% gain had “higher proportions of underweight and normal BMI at baseline, female, age <50, and psychiatric disorders and lower rates of comorbidities chronic kidney disease, cardiovascular disease, diabetes, hyperlipidemia, and hypogonadism.”

The weight gain patients were less commonly treated with protease inhibitor-containing ART and more commonly treated with integrase strand transfer inhibitor-containing ART.

Logistic regression determined that factors identified as negatively associated with weight gain were being overweight or obese at baseline, hypogonadism, and use of protease inhibitor-containing therapies. Integrase strand transfer inhibitor-containing ART was not significantly associated with weight gain in the logic regression. Additionally, psychiatric disorders were positively associated with weight gain via logic regression.

Overall, the study found that weight gain in the treatment-experienced individuals with HIV suppression was associated with lower BMI, reduced proportion of hypogonadism, increased proportion of psychiatric disorders, and non-protease inhibitor-containing regimens.

“The association between integrase strand transfer inhibitor-based ART and weight gain, which reached significance in bivariate analyses, did not remain significant in LR, suggesting that in this population, weight changes are primarily driven by other factors,” the investigators conclude.

The study, “Weight Gain During Treatment Among 3,468 Treatment-Experienced Adults With HIV,” was presented on March 6, 2019, at CROI 2019 in Seattle, Washington.

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