Giovanni Guaraldi1, Stefano Calza2, Jovana Milic1, Andrea Calcagno3, Emanuele Focà4, Matteo Rota2, Stefano Renzetti2, Anna Celotti4, Matteo Siano5, Benedetto Maurizio Celesia6, Stefania Piconi7, Giuseppe Vittorio de Socio8, Anna Maria Cattelan9, Giancarlo Orofino10, Agostino Riva5, Silvia Nozza11, Giovanni di Perri3. 1. Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena. 2. Department of Molecular and Translational Medicine, University of Brescia, Brescia. 3. Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin. 4. Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili of Brescia, Brescia. 5. Third Division of Infectious Diseases, University of Milan, Ospedale L. Sacco, Milan. 6. ARNAS 'Garibaldi' UOC Malattie Infettive Catania, Catania. 7. First Division of Infectious Diseases Unit, University of Milan, Ospedale L. Sacco, Milan. 8. Department of Medicine, Infectious Diseases Unit, Azienda Ospedaliera di Perugia and University of Perugia, Santa Maria Hospital, Perugia. 9. Unit of Infectious Diseases, Department of Internal Medicine, Azienda Ospedaliera-Universitaria di Padova, Padova. 10. Unit of Infectious Diseases, Division A, Ospedale Amedeo di Savoia, Turin. 11. Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy.
Abstract
OBJECTIVE: The aim of this study was to explore weight gain in people with HIV (PWH) at least 65 years of age who switch to a DTG based regimen (DTG-s) vs. remaining INSTI-naive (INSTI-n) on stable ART. METHODS: This was a longitudinal prospective study of PWH from the GEPPO cohort. At the beginning of the observational period, participants were INSTI-naives (INSTI-n). During follow-up, they were divided in two groups: INSTI-n vs. dolutegravir-switchers (DTG-s) with no further change in ART. Body weight was assessed at baseline and at last follow-up visit. Significant weight gain was defined as an increase at least 5% of baseline weight from the first to the last visit. ART regimens were collected at each patients' visit. Kaplan--Meier curves were drawn to assess time to reach a weight gain more than 5%. RESULTS: Out of 568 PWH (83.1% men, median age 69.5 years), 427 (75%) were INSTI-n and 141 (25%) DTG-s. After an average follow-up of 2.6 (±0.8) years, no significant change in body weight was observed both among INSTI-n [delta weight = 0.02 (±7.5), P = 0.633] and DTG-s [delta weight = -0.04 (±5.2), P = 0.755]. Weight gain was also not significantly different between study groups (9.3% in INSTI-n and 15.1% in DTG-S: P = 0.175). No significant differences in time to achieve a weight gain greater or equal than 5% of baseline weight emerged in INSTI-n vs. DTG-s (P = 0.93), two-drug regimens (2DR) vs. three-drug regimens (3DR) (P = 0.56) or TAF vs. TDF (P = 0.56). CONCLUSION: Results from a large Italian cohort did not show a significant weight gain associated with switch to DTG in PWH 65 years of age or older. This finding emerged also when comparing 3DR vs. 2DR and TAF exposed and unexposed geriatric PWH.
OBJECTIVE: The aim of this study was to explore weight gain in people with HIV (PWH) at least 65 years of age who switch to a DTG based regimen (DTG-s) vs. remaining INSTI-naive (INSTI-n) on stable ART. METHODS: This was a longitudinal prospective study of PWH from the GEPPO cohort. At the beginning of the observational period, participants were INSTI-naives (INSTI-n). During follow-up, they were divided in two groups: INSTI-n vs. dolutegravir-switchers (DTG-s) with no further change in ART. Body weight was assessed at baseline and at last follow-up visit. Significant weight gain was defined as an increase at least 5% of baseline weight from the first to the last visit. ART regimens were collected at each patients' visit. Kaplan--Meier curves were drawn to assess time to reach a weight gain more than 5%. RESULTS: Out of 568 PWH (83.1% men, median age 69.5 years), 427 (75%) were INSTI-n and 141 (25%) DTG-s. After an average follow-up of 2.6 (±0.8) years, no significant change in body weight was observed both among INSTI-n [delta weight = 0.02 (±7.5), P = 0.633] and DTG-s [delta weight = -0.04 (±5.2), P = 0.755]. Weight gain was also not significantly different between study groups (9.3% in INSTI-n and 15.1% in DTG-S: P = 0.175). No significant differences in time to achieve a weight gain greater or equal than 5% of baseline weight emerged in INSTI-n vs. DTG-s (P = 0.93), two-drug regimens (2DR) vs. three-drug regimens (3DR) (P = 0.56) or TAF vs. TDF (P = 0.56). CONCLUSION: Results from a large Italian cohort did not show a significant weight gain associated with switch to DTG in PWH 65 years of age or older. This finding emerged also when comparing 3DR vs. 2DR and TAF exposed and unexposed geriatric PWH.
Authors: Wei Li A Koay; Sahera Dirajlal-Fargo; Matthew E Levy; Paige Kulie; Anne Monroe; Amanda D Castel; Natella Y Rakhmanina Journal: Open Forum Infect Dis Date: 2021-07-01 Impact factor: 3.835