Weight Change Following Switch to Dolutegravir for HIV Treatment in Rural Kenya During Country Roll-Out

作者：Matthew D. Hickey, Erick Mugoma Wafula, Sabina Ogachi, Hellen Ojwando, Gordon Orori, Richard O. Adede, Lucas Godoy Garraza, Maya L Petersen, Diane V. Havlir, Laura B. Balzer, James Ayieko · 发表于：JAIDS Journal of Acquired Immune Deficiency Syndromes · 年份：2023 · DOI：10.1097/qai.0000000000003173 · 被引用次数：12 · 研究领域：HIV-related health complications and treatments、HIV/AIDS drug development and treatment、HIV/AIDS Research and Interventions

INTRODUCTION: Switch to dolutegravir (DTG) in treatment-experienced people living with HIV (PLH) is associated with excess weight gain in some settings; data are limited from rural low-income settings with low obesity prevalence. METHODS: In rural Kenya, we conducted a retrospective cohort study at 8 HIV clinics and a single-site prospective cohort study including adults switching to DTG during countrywide transition to DTG/tenofovir DF(TDF)/emtricitabine as first-line HIV treatment. In the retrospective analysis, we used preswitch data to model postswitch weight trajectory had each participant not switched to DTG and contrasted observed vs. predicted postswitch weight. In the prospective analysis, we measured weight post-DTG switch and evaluated predictors of 6-month weight change. RESULTS: Our retrospective cohort included 4445 PLH who switched to DTG between 2018 and 2020. Mean 12-month weight change was 0.6 kg preswitch and 0.8 kg postswitch. Among those on TDF throughout (n = 3374; 83% on efavirenz preswitch), 12-month postswitch weight was 0.7 kg more than predicted for women (95% CI: 0.4, 1.0) and similar among men (0.04 kg; 95% CI -0.3, 0.4). In our prospective cohort (n = 135, 100% female), mean 6-month weight change was +0.4 kg (IQR -1.1, 2.0 kg). Predicted gain varied by baseline food insecurity: +1.1 kg (95% CI: 0.34, 1.87) among food secure, -0.09 kg (95% CI -0.71, 0.54) among moderate insecure, and +0.27 kg (95% CI -0.82, 1.36) among severe insecurity. CONCLUSIO...