ABSTRACT
Background:
Excessive weight gain is a current concern among People Living with HIV (PLHIV) starting ART.
Objectives:
To evaluate the weight gain after 48-weeks of ART in naive patients, according with baseline CD4 count.
Methods:
PLHIV starting 3TC + TDF + DTG with at least 48-weeks of follow up in two AIDS referral centers were stratified by baseline CD4 count (lower or higher than 200 cells/mm3). Data on CD4 count, HIV viral load, weight/Body Mass Index (BMI), lipids and glucose levels were collected at baseline, 24 and 48 weeks of treatment. For analysis purpose, patients were categorized according to their BMI progression.
Results:
A total of 270 patients were included in the study. Mean CD4 count were 78.3 ± 61.7 and 536.7 ± 273 cells/mm3 for low and high CD4 count groups, respectively (p < 0.001). Baseline BMI was significantly lower in low CD4 group (21.7 vs. 23.6 Kg/m2, p < 0.001). Patients in low CD4 group gained more weight than those in high CD4 group (11.2 ± 8.5 kg vs. 2.2 ± 4.2 Kg, p = 0.004). Overall weight gain was higher in women, regardless group (13.1 ± 7.9 Kg vs. 1.4 ± 3.6 Kg for women and men, respectively, p < 0.001). The proportion of overweight/obesity significantly increased in low CD4 group. Viral suppression rate was high for both groups. At week 48 the overall proportion of overweight/obesity was like that reported for the Brazilian population.
Conclusions:
Weight gain in the present study indicates a “return to health” phenomenon. Excessive weight gain was more frequent in women.
Keywords:
Dolutegravir; Weight gain; CD4; Obesity
Key points
Weight gain is a current concern in PLHIV starting INSTI-based ART. Our findings suggest weight gain is a return to health phenomenon, rather than a drug-related adverse event, and is associated with female sex and low CD4 count at baseline.
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