Share
Title
Effect on weight changes upon discontinuation of dolutegravir from antiretroviral regimens among persons with HIV who experienced weight gain
Presenter
Jeffrey Yin
Authors
J. Yin1, L. Hill1, N. Patel1, M. Horberg2, C. Lahiri3, K. Althoff4, J. Colasanti3, J. Lake5, J.R. Koethe6, P. Rebeiro6, J. Gill7, M. Karris1, C. Rentsch8, T. Brown4, S. Napravnik9, North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA
Institutions
1University of California San Diego, San Diego, United States, 2Kaiser Permanente Mid-Atlantic States, Rockville, United States, 3Emory University School of Medicine, Atlanta, United States, 4Johns Hopkins University, Baltimore, United States, 5University of Texas Health Houston, Houston, United States, 6Vanderbilt University Medical Center, Nashville, United States, 7University of Calgary, Calgary, Canada, 8London School of Hygiene and Tropical Medicine, London, United Kingdom, 9University of North Carolina School of Medicine, Chapel Hill, United States

BACKGROUND: Weight gain associated with dolutegravir (DTG) has been documented extensively. Among those experiencing weight gain, it is unclear if discontinuation of DTG results in weight loss. The study objective was to describe the changes in weight while on DTG to changes in weight after discontinuing DTG.
METHODS: A retrospective cohort study was performed among PWH (persons with HIV) in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) between 1/2010 - 12/2020. Inclusion criteria were: age =18 years, receipt of a DTG-containing regimen for =12 months followed by removing DTG from HIV regimen for =12 months, non-missing weight measurements, and any weight gain while on DTG. The mean weights during the pre-(-12 to – 6 months)/peri- (-3 to + 3 months)/post- (+6 to +12 months) discontinuation periods were used for analysis. Wilcoxon signed rank test was used to compare median weight changes in PWH between pre-/peri- DTG removal and peri-/post- DTG removal. Comparisons of weight change by concomitant agents were performed using the Mann Whitney U test.
RESULTS: Among the 176 PWH, mean (SD) age was 48.1 (12.1) years and 70% were male. Median (IQR) weight at time of DTG discontinuation was 85.4kg (74.2 – 99.9). Change in median (IQR) weight starting 12 months before discontinuing DTG to time of discontinuation was +2.7 (+1.3 – +4.8) kilograms compared to weight change after discontinuation +0.7 (-1.1 – +3), p<0.001. There were no significant differences in weight change after discontinuing DTG between recipients of elvitegravir (p=0.26), protease inhibitors (p=0.80) and non-nucleoside reverse transcript inhibitors (p=0.99) in subsequent regimen. Median (IQR) change in weight after discontinuing DTG was not different between those with/without tenofovir alafenamide in the subsequent regimen (+0.7 [-1.0 – +3.0] vs +0.8 [-2.3 – +3.5] kilograms, p=0.88). Similarly, no difference in median (IQR) weight change was observed in those with/without tenofovir disoproxil fumarate in subsequent regimen (+0.6 (-2.4 – +2.9) vs +0.7 (-1.1 – +3.1), p=0.44).
CONCLUSIONS: Rate of weight change was significantly different before/after discontinuation of DTG. Future studies needed to elucidate the effect of contributory factors such as CD4 restoration, underlying body size, optimal time and amount of weight resolution possible.

Download the e-Poster (PDF)