Jordan E Lake1, Janine Trevillyan2. 1. Division of Infectious Diseases, University of Texas Health Science Center, Houston, Texas, USA. 2. Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia.
Abstract
PURPOSE OF REVIEW: Obesity is increasing in people with HIV (PWH). This review aims to summarise the recent evidence investigating the associations between the use of integrase inhibitors and tenofovir alafenamide (TAF) with weight gain and the mechanisms by which this may occur. Understanding the role that antiretroviral therapies play in promoting weight gain is critical in making informed treatment decisions. RECENT FINDINGS: Weight gain is common with antiretroviral therapies and can lead to significant medical complications for PWH. Antiretroviral regimens containing an integrase inhibitor in conjunction with TAF are associated with the greatest degree of weight gain. This weight gain is greatest with dolutegravir and bictegravir compared with other integrase inhibitors. Some of the measured weight gain attributed to TAF may actually reflect a loss of weight suppressant effects of tenofovir disoproxil fumarate, and thus the exact proportional contribution of TAF remains to be seen. The mechanisms by which advent of antiretroviral therapy may be promoting weight gain is still being determined but underlying genetic risks factors and gender are very important determinants of the degree of weight gained. SUMMARY: Integrase inhibitors and TAF contribute to weight gain in PWH. This places them at risk for potentially serious medical complications.
PURPOSE OF REVIEW: Obesity is increasing in people with HIV (PWH). This review aims to summarise the recent evidence investigating the associations between the use of integrase inhibitors and tenofovir alafenamide (TAF) with weight gain and the mechanisms by which this may occur. Understanding the role that antiretroviral therapies play in promoting weight gain is critical in making informed treatment decisions. RECENT FINDINGS: Weight gain is common with antiretroviral therapies and can lead to significant medical complications for PWH. Antiretroviral regimens containing an integrase inhibitor in conjunction with TAF are associated with the greatest degree of weight gain. This weight gain is greatest with dolutegravir and bictegravir compared with other integrase inhibitors. Some of the measured weight gain attributed to TAF may actually reflect a loss of weight suppressant effects of tenofovir disoproxil fumarate, and thus the exact proportional contribution of TAF remains to be seen. The mechanisms by which advent of antiretroviral therapy may be promoting weight gain is still being determined but underlying genetic risks factors and gender are very important determinants of the degree of weight gained. SUMMARY: Integrase inhibitors and TAF contribute to weight gain in PWH. This places them at risk for potentially serious medical complications.
Authors: Giada Sebastiani; Jovana Milic; Adriana Cervo; Sahar Saeed; Thomas Krahn; Dana Kablawi; Al Shaima Al Hinai; Bertrand Lebouché; Philip Wong; Marc Deschenes; Claudia Gioè; Antonio Cascio; Giovanni Mazzola; Giovanni Guaraldi Journal: J Pers Med Date: 2022-02-15
Authors: Myrthe L Verburgh; Ferdinand W N M Wit; Anders Boyd; Sebastiaan O Verboeket; Peter Reiss; Marc van der Valk Journal: Open Forum Infect Dis Date: 2022-06-10 Impact factor: 4.423