دورية أكاديمية
أعرض في EDS

Assessment of weight gain in adult patients living with HIV receiving first-line dolutegravir-based or efavirenz-based ART regimens in routine care clinics in Tshwane district, South Africa: An observational study.

التفاصيل البيبلوغرافية
العنوان: Assessment of weight gain in adult patients living with HIV receiving first-line dolutegravir-based or efavirenz-based ART regimens in routine care clinics in Tshwane district, South Africa: An observational study.
المؤلفون: Sawry S; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa., Ayalew K; Division of Global HIV and TB, Centers for Disease Control and Prevention (CDC), Pretoria, South Africa., Maimela G; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa., Briggs-Hagen M; Division of Global HIV and TB, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA., van Wyk-Heath M; Division of Global HIV and TB, Centers for Disease Control and Prevention (CDC), Pretoria, South Africa., Mthethwa S; Division of Global HIV and TB, Centers for Disease Control and Prevention (CDC), Pretoria, South Africa., Shai S; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa., Mngomezulu NN; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa., Tlhowe L; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa., Achere-Darko J; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa., Bedford J; Division of Global HIV and TB, Centers for Disease Control and Prevention (CDC), Pretoria, South Africa., Martin CE; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa., Fairlie L; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa., Imrie J; Wits RHI, University of the Witwatersrand, Johannesburg, South Africa.
المصدر: HIV medicine [HIV Med] 2024 Jul; Vol. 25 (7), pp. 826-839. Date of Electronic Publication: 2024 Mar 22.
نوع المنشور: Journal Article; Observational Study
اللغة: English
بيانات الدورية: Publisher: Wiley Country of Publication: England NLM ID: 100897392 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-1293 (Electronic) Linking ISSN: 14642662 NLM ISO Abbreviation: HIV Med Subsets: MEDLINE
أسماء مطبوعة: Publication: Oxford : Wiley
Original Publication: Oxford : Blackwell Science, c1999-
مواضيع طبية MeSH: Weight Gain*/drug effects , HIV Infections*/drug therapy , Pyridones* , Heterocyclic Compounds, 3-Ring*/therapeutic use , Heterocyclic Compounds, 3-Ring*/adverse effects , Heterocyclic Compounds, 3-Ring*/administration & dosage , Oxazines*/therapeutic use , Benzoxazines*/therapeutic use , Benzoxazines*/adverse effects , Benzoxazines*/administration & dosage , Alkynes* , Cyclopropanes*, Humans ; Male ; Female ; Adult ; South Africa ; Retrospective Studies ; Middle Aged ; Piperazines ; Anti-HIV Agents/therapeutic use ; Anti-HIV Agents/adverse effects ; Longitudinal Studies ; Body Mass Index ; Lamivudine/therapeutic use ; Lamivudine/adverse effects ; Lamivudine/administration & dosage ; Tenofovir/therapeutic use ; Tenofovir/adverse effects ; Tenofovir/administration & dosage ; Emtricitabine/therapeutic use ; Emtricitabine/administration & dosage
مستخلص: Introduction: Although dolutegravir (DTG) is deemed stable, safe, cost-effective, and clinically beneficial, it also carries the risk of side effects, including observed weight gain among patients on DTG-based antiretroviral therapy (ART) regimens. We compared weight changes among adults (≥18 years) initiating tenofovir disoproxil fumarate, lamivudine, and dolutegravir (TLD) or tenofovir disoproxil fumarate, emtricitabine, and efavirenz (TEE) regimens and those switching from TEE to TLD (TEE-to-TLD switchers) in three large primary care facilities in South Africa METHODS: We conducted a retrospective longitudinal record review using patient medical records, extracting relevant demographic and clinical data from October 2018 to June 2021 from randomly selected adults who initiated TLD or TEE (initiators) and adult TEE-to-TLD switchers. We assessed weight, body mass index (BMI), and percentage weight changes for both groups and fitted linear regression and generalized linear models to determine factors associated with weight and BMI change and percentage weight change ≥10%, respectively, among treatment initiators. We fitted linear mixed-effect models among TEE-to-TLD switchers to consider repeated measures.
Results: Of 860 initiators, 450 (52.3%) initiated on TEE and 410 (47.7%) on TLD, with median follow-up of 1.4 years and 1.0 year, respectively. At initiation, 43.3% on TEE and 40.8% on TLD were overweight or obese. TLD initiators had an adjusted higher mean weight gain of 1.6 kg (p < 0.001) and mean BMI gain of 0.51 kg/m 2 (p < 0.001) than TEE initiators. Independent risk factors for higher mean weight and BMI included age ≥50 years, male, on ART for >12 months, initial BMI of <18.5 kg/m 2 , and CD4 counts <200 cells/μL. Of 298 TEE-to-TLD switchers, 36.6% were overweight or obese at TEE initiation. Comparing before and after TLD switch, TEE-to-TLD switchers had an adjusted mean weight of 1.2 kg less while on TLD (p = 0.026). Being overweight and CD4 counts >350 cells/μL were independent risk factors for lower weight gain after TLD switch.
Conclusions: We report more weight gain among TLD than among TEE initiators, although to a lesser extent than previously reported. TEE-to-TLD switchers experienced less weight gain after TLD switch; return to health before receiving TLD may be a contributory factor. The current findings are reassuring for those switching to a DTG-based regimen.
(© 2024 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.)
References: Br J Clin Pharmacol. 2022 Mar;88(3):883-893. (PMID: 34954840)
N Engl J Med. 2019 Aug 29;381(9):816-826. (PMID: 31339676)
HIV Med. 2016 Apr;17(4):255-68. (PMID: 26216031)
AIDS. 2021 Dec 15;35(Suppl 2):S117-S125. (PMID: 34261099)
BMJ. 2019 Jul 23;366:l4831. (PMID: 31337663)
EClinicalMedicine. 2022 May 12;48:101412. (PMID: 35706487)
Lancet HIV. 2020 Oct;7(10):e666-e676. (PMID: 33010240)
J Int AIDS Soc. 2021 May;24(5):e25732. (PMID: 34036745)
Lancet HIV. 2016 Nov;3(11):e510-e520. (PMID: 27658869)
EClinicalMedicine. 2023 Feb 06;57:101836. (PMID: 36816348)
N Engl J Med. 2019 Aug 29;381(9):803-815. (PMID: 31339677)
J Biomed Inform. 2019 Jul;95:103208. (PMID: 31078660)
South Afr J HIV Med. 2020 Jul 08;21(1):1079. (PMID: 32832113)
Pan Afr Med J. 2019 May 15;33:30. (PMID: 31384345)
J Acquir Immune Defic Syndr. 2016 Oct 1;73(2):228-36. (PMID: 27171741)
Curr HIV/AIDS Rep. 2020 Apr;17(2):138-150. (PMID: 32072466)
J Int AIDS Soc. 2022 Apr;25(4):e25899. (PMID: 35419973)
Multivariate Behav Res. 2011 May;46(3):399-424. (PMID: 21818162)
Clin Infect Dis. 2023 Apr 17;76(8):1492-1495. (PMID: 36519389)
Lancet HIV. 2019 Feb;6(2):e116-e127. (PMID: 30503325)
BMC Public Health. 2016 Apr 29;16:365. (PMID: 27129700)
South Afr J HIV Med. 2023 May 15;24(1):1500. (PMID: 37293606)
معلومات مُعتمدة: United States CC CDC HHS; United States CC CDC HHS
فهرسة مساهمة: Keywords: ART; HIV; dolutegravir; routine care; weight gain
المشرفين على المادة: 0 (Pyridones)
0 (Heterocyclic Compounds, 3-Ring)
DKO1W9H7M1 (dolutegravir)
0 (Oxazines)
0 (Benzoxazines)
0 (Alkynes)
JE6H2O27P8 (efavirenz)
0 (Cyclopropanes)
0 (Piperazines)
0 (Anti-HIV Agents)
2T8Q726O95 (Lamivudine)
99YXE507IL (Tenofovir)
G70B4ETF4S (Emtricitabine)
تواريخ الأحداث: Date Created: 20240323 Date Completed: 20240705 Latest Revision: 20240724
رمز التحديث: 20240725
مُعرف محوري في PubMed: PMC11263972
DOI: 10.1111/hiv.13638
PMID: 38520085
قاعدة البيانات: MEDLINE
الوصف
تدمد:1468-1293
DOI:10.1111/hiv.13638