Bansi-Matharu, Loveleen, Phillips, Andrew, Oprea, Cristiana, Grabmeier-Pfistershammer, Katharina, Gunthard, Huldrych F., De Wit, Stephane, Guaraldi, Giovanni, Vehreschild, Jorg J., Wit, Ferdinand, Law, Matthew, Wasmuth, Jan-Christian, Chkhartishvili, Nikoloz, Monforte, Antonella d'Arminio, Fontas, Eric, Vesterbacka, Jan, Miro, Jose M., Castagna, Antonella, Stephan, Christoph, Llibre, Josep M., Neesgaard, Bastian, Greenberg, Lauren, Smith, Colette ORCID: 0000-0003-2847-3355, Kirk, Ole, Duvivier, Claudine, Dragovic, Gordana, Lundgren, Jens, Dedes, Nikos, Knudsen, Andreas, Gallant, Joel, Vannappagari, Vani, Peters, Lars, Elbirt, Daniel, Sarcletti, Mario, Braun, Dominique L., Necsoi, Coca, Mussini, Cristina ORCID: 0000-0002-6615-4198, Muccini, Camilla, Bolokadze, Natalie, Hoy, Jennifer, Mocroft, Amanda and Ryom, Lene (2021). Contemporary antiretrovirals and body-mass index: a prospective study of the RESPOND cohort consortium. Lancet HIV, 8 (11). S. E711 - 12. SAN DIEGO: ELSEVIER INC. ISSN 2352-3018

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Abstract

Background Weight gain effects of individual antiretroviral drugs are not fully understood. We investigated associations between a prespecified clinically significant increase (>7%) in body-mass index (BMI) and contemporary antiretroviral use. Methods The International Cohort Consortium of Infectious Diseases (RESPOND) is a prospective, multicohort collaboration, including data from 17 well established cohorts and over 29 000 people living with HIV. People with HIV under prospective follow-up from Jan 1, 2012, and older than 18 years were eligible for inclusion. Each cohort contributed a predefined minimum number of participants related to the size of the specific cohort (with a minimum of 1000 participants). Participants were required to have CD4 cell counts and HIV viral load measurement in the 12 months before or within 3 months after baseline. For all antiretroviral drugs received at or after RESPOND entry, changes from pre-antiretroviral BMI levels (baseline) were considered at each BMI measurement during antiretroviral treatment. We used logistic regression to identify individual antiretrovirals that were associated with first occurrence of a more than 7% increase in BMI from pre-antiretroviral BMI. We adjusted analyses for time on antiretrovirals, pre-antiretroviral BMI, demographics, geographical region, CD4 cell count, viral load, smoking status, and AIDS at baseline. Findings 14 703 people were included in this study, of whom 7863 (53middot5%) had a more than 7% increase in BMI. Compared with lamivudine, use of dolutegravir (odds ratio [OR] 1middot27, 95% CI 1middot17-1middot38), raltegravir (1middot37, 1middot20-1middot56), and tenofovir alafenamide (1middot38, 1middot22-1middot35) was significantly associated with a more than 7% BMI increase, as was low pre-antiretroviral BMI (2middot10, 1middot91-2middot31 for underweight vs healthy weight) and Black ethnicity (1middot61, 1middot47-1middot76 vs White ethnicity). Higher CD4 count was associated with a reduced risk of BMI increase (0middot97, 0middot96-0middot98 per 100 cells per mu L increase). Relative to lamivudine, dolutegravir without tenofovir alafenamide (OR 1middot21, 95% CI 1middot19-1middot32) and tenofovir alafenamide without dolutegravir (1middot33, 1middot15-1middot53) remained independently associated with a more than 7% increase in BMI; the associations were higher when dolutegravir and tenofovir alafenamide were used concomitantly (1middot79, 1middot52-2middot11, and 1middot70, 1middot44-2middot01, respectively). Interpretation Clinicians and people with HIV should be aware of associations between weight gain and use of dolutegravir, tenofovir alafenamide, and raltegravir, particularly given the potential consequences of weight gain, such as insulin resistance, dyslipidaemia, and hypertension. Funding The CHU St Pierre Brussels HIV Cohort, The Austrian HIV Cohort Study, The Australian HIV Observational Database, The AIDS Therapy Evaluation in the Netherlands national observational HIV cohort, The EuroSIDA cohort, The Frankfurt HIV Cohort Study, The Georgian National AIDS Health Information System, The Nice HIV Cohort, The ICONA Foundation, The Modena HIV Cohort, The PISCIS Cohort Study, The Swiss HIV Cohort Study, The Swedish InfCare HIV Cohort, The Royal Free HIV Cohort Study, The San Raffaele Scientific Institute, The University Hospital Bonn HIV Cohort and The University of Cologne HIV Cohorts, ViiV Healthcare, and Gilead Sciences. Copyright (c) 2021 Elsevier Ltd. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bansi-Matharu, LoveleenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Phillips, AndrewUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oprea, CristianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grabmeier-Pfistershammer, KatharinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gunthard, Huldrych F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Wit, StephaneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guaraldi, GiovanniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Jorg J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wit, FerdinandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Law, MatthewUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wasmuth, Jan-ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chkhartishvili, NikolozUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Monforte, Antonella d'ArminioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fontas, EricUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vesterbacka, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Miro, Jose M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Castagna, AntonellaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stephan, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Llibre, Josep M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neesgaard, BastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Greenberg, LaurenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smith, ColetteUNSPECIFIEDorcid.org/0000-0003-2847-3355UNSPECIFIED
Kirk, OleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duvivier, ClaudineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dragovic, GordanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lundgren, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dedes, NikosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Knudsen, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gallant, JoelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vannappagari, VaniUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Peters, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Elbirt, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sarcletti, MarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braun, Dominique L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Necsoi, CocaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mussini, CristinaUNSPECIFIEDorcid.org/0000-0002-6615-4198UNSPECIFIED
Muccini, CamillaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bolokadze, NatalieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoy, JenniferUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mocroft, AmandaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ryom, LeneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-607101
DOI: 10.1016/S2352-3018(21)00163-6
Journal or Publication Title: Lancet HIV
Volume: 8
Number: 11
Page Range: S. E711 - 12
Date: 2021
Publisher: ELSEVIER INC
Place of Publication: SAN DIEGO
ISSN: 2352-3018
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TENOFOVIR DISOPROXIL FUMARATE; INDUCED WEIGHT-GAIN; ALAFENAMIDE; HIV; DOLUTEGRAVIR; PREDICTORS; INFECTION; EFAVIRENZMultiple languages
Immunology; Infectious DiseasesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60710

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