H5. Complications and co-infections
Oral Abstract Submission
Karam Mounzer, MD
Clinical Professor of Medicine
Disclosure: Epividian: Board Member
Gilead Sciences: Consultant, Grant/Research Support, Speaker's Bureau
Janssen and Janssen: Consultant, Grant/Research Support, Speaker's Bureau
Merck: Grant/Research Support, Speaker's Bureau
ViiV healthcare: Consultant, Grant/Research Support, Speaker's Bureau
Ricky Hsu, MD
Associate Clinical Professor and Northern U.S. Medical Director AHF
NYU Langone Medical Center - AIDS Healthcare Foundation
New York, NY
Disclosure: Gilead: Advisor or Review Panel member, Research Grant or Support, Speaker's Bureau
Janssen: Advisor or Review Panel member, Speaker's Bureau
Merck: Research Grant or Support, Speaker's Bureau
ViiV: Grant/Research Support, Advisor or Review Panel member, Speaker's Bureau
A potential association between integrase inhibitor (INSTI) use and weight gain has been reported in people living with HIV (PLWH). We examined body mass index (BMI) increases after a switch to dolutegravir (DTG), elvitegravir/cobicistat (EVG/c), raltegravir (RAL), rilpivirine (RPV), or boosted darunavir (bDRV) among virologically suppressed ART-experienced PLWH.
ART-experienced, suppressed (ART-ES; baseline viral load < 200 copies/mL) PLWH ≥ 18 years of age initiating DTG, EVG/c, RAL, RPV or bDRV for the first time were identified in the OPERA® cohort. The association between core agents and mean increases in BMI at 6, 12, and 24 months was estimated with multivariable linear regression. Inverse probability-of-censoring weights (IPCW) were used to account for censoring (regimen discontinuation, loss to follow-up, death, pregnancy, or no BMI measured). Analyses were stratified by baseline BMI categories (underweight: < 18.5, normal weight: ≥ 18.5 to < 25, overweight: ≥ 25 to < 30, obese: ≥ 30).
At baseline, endocrine disorders were reported in > 40% of PLWH receiving DTG and RAL; > 60% were overweight/obese in all groups (Fig 1). Mean BMI (unadjusted) increased for all ARVs over time, with changes at 24 months ranging from 0.30 (DRV) to 0.83 (RPV, Fig 2). At 6 months, the adjusted mean BMI increase was statistically smaller with EVG/c, RAL, and bDRV (range - 0.15 to - 0.30) than with DTG (Fig 3); these differences only remained significantly different for bDRV at 12 (- 0.29) and 24 months (- 0.29, Fig 3). Among those with a normal baseline BMI, the adjusted mean change in BMI at 12 months was smaller with EVG/c, bDRV and RAL than DTG (range - 0.26 to - 0.27). Among overweight PLWH, the adjusted mean BMI increase was statistically smaller with bDRV than DTG (‑ 0.32, Fig 4). Results were consistent in IPCW estimates.