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Title
Changes in weight and body mass index associated with dolutegravir- and non-dolutegravir-based antiretroviral treatment regimens: a longitudinal analysis
Presenter
Rogers Ajeh
Authors
R. Ajeh1,2, E. Brazier3,4, A. Dzudie2,5, G. Murenzi6,7, D. Mahambou8, T. Niyongabo9, P. Lelo10, M. Yotebieng11, D. Nash12,4, K. Anastos11
Institutions
1National AIDS Control Committee, Ministry of Health, Yaounde, Cameroon, 2Clinical Research Education Networking and Consultancy, Yaounde, Cameroon, 3New York City University, Institute for Implementation Science in Population Health, New York, United States, 4City University of New York, Graduate School of Public Health and Health Policy,, New York, United States, 5Douala General Hospital, Douala, Cameroon, 6Research for Development, Kigali, Rwanda, 7Military Hospital, Kigali, Rwanda, 8Centre de Traitement Ambulatoire of Brazzaville, Brazzaville, Congo, 9National Reference Center for HIV/AIDS, Bujumbura, Burundi, 10Kalembelembe Pediatric Hospital, Department of Infectious Diseases, Kinshasa, Congo, Democratic Republic of the, 11Albert Einstein College of Medicine, New York, United States, 12City University of New York, Institute for Implementation Science in Population Health, New York, United States

BACKGROUND: While limited, evidence of the effects of dolutegravir (DTG)-based antiretroviral therapy (ART) regimens suggests that they are associated with weight gain. This study aimed to compare weight gain and body mass index (BMI) among patients on DTG- and non-DTG ART regimens in the Central Africa International epidemiology Databases to Evaluate AIDS cohort.
METHODS: All ART-naïve adults (=19 years) initiating ART between 2018 and 2020 at 21 HIV clinics in Burundi, Cameroon, Democratic Republic of Congo, Congo and Rwanda with a weight measure within 3 months of ART initiation and at 12 months (±3 months) after ART initiation. Mean weight and BMI changes at 12 months after ART initiation, were computed. Linear regression models were used to estimate unadjusted and adjusted differences in weight and BMI associated with DTG use. Among patients with normal baseline BMI (18.5-24kg/m2), predictors of >10% weight gain were determined using modified Poisson regression.
RESULTS: Of 3,418 adults initiating ART, 1,116 initiated DTG regimens and 2,032 non-DTG regimens. Women comprised 61.5% of patients overall but only 49.6% of those on DTG. Mean age was 39 years among men (95%CI:38.3-39.4) and 35 years among women (95%CI: 34.9-35.9, p<0.0001). Mean weight at baseline was 59.1kg (95%CI: 58.3-59.8) and 60.1kg (95%CI: 59.6-60.7) among patients on DTG- and non-DTG regimens, respectively (p=0.023). Baseline BMI (22.5 kg/m2) did not differ by DTG use. Absolute changes in mean weight at 12 (±3) months were +2.62kg (95%CI: 2.14-3.10) in DTG patients and +1.99kg (95%CI: 1.64-2.35) in non-DTG patients (p=0.04). BMI changes were +0.73kg/m2 (95%CI: 0.62-0.84) and +0.97kg/m2 (95%CI: 0.78-1.16), respectively (p=0.03). Among patients with normal baseline BMI, 18.8% had >10% increase in weight, with no difference by regimen type (aRR: 1.08; 95%CI: 0.81-1.44). Being female (aRR: 1.33 95%CI: 1.08-1.66), having advanced HIV disease (aRR: 1.82; 95%CI: 1.45-2.29) and ART initiation age =30 were associated with >10% weight gain.
CONCLUSIONS: While DTG regimens were associated with greater weight and BMI increases by 12 months, but was not associated with >10% weight increases among those with normal baseline BMI. Further research is necessary to assess longer-term DTG-associated weight gain and its clinical implications.