Changes in Body Mass Index Associated with Antiretroviral Regimen Switch Among Treatment-Experienced, Virologically Suppressed People Living with HIV in the United States
With obesity on the rise among people living with HIV (PLWH), there is growing concern that weight gain may result as an undesired effect of antiretroviral therapy (ART). This analysis sought to assess the association between ART regimens and changes in body mass index (BMI) among ART-experienced, v...
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Veröffentlicht in: | AIDS research and human retroviruses 2021-11, Vol.37 (11), p.852-861 |
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creator | Mounzer, Karam Brunet, Laurence Hsu, Ricky Fusco, Jennifer Vannappagari, Vani Henegar, Cassidy van Wyk, Jean Crawford, Melissa Lo, Janet Fusco, Gregory |
description | With obesity on the rise among people living with HIV (PLWH), there is growing concern that weight gain may result as an undesired effect of antiretroviral therapy (ART). This analysis sought to assess the association between ART regimens and changes in body mass index (BMI) among ART-experienced, virologically suppressed PLWH. ART-experienced, virologically suppressed PLWH ≥18 years of age in the Observational Pharmacoepidemiology Research and Analysis (OPERA) cohort were included for analysis if prescribed a new regimen containing one of the following core agents: dolutegravir (DTG), elvitegravir/cobicistat (EVG/c), raltegravir (RAL), rilpivirine (RPV), or boosted darunavir (bDRV), for the first time between August 1, 2013 and December 31, 2017. Multivariable linear regression was used to assess the association between regimen and mean changes in BMI at 6, 12, and 24 months after switch. In unadjusted analyses, BMI increases ranged from 0.30 kg/m2 (bDRV) to 0.83 kg/m2 (RPV) at 24 months following switch, but gains were observed with every regimen. In adjusted analyses, compared to DTG, only bDRV was associated with a smaller increase in BMI at all time points, while EVG/c and RAL were associated with smaller increases in BMI at 6 months only. Overall, results were consistent in analyses stratified by baseline BMI category. BMI increases were relatively small but followed an upward trend over time in this cohort of treatment-experienced, suppressed PLWH. Gains were attenuated with a longer period of follow-up. BMI gains did not differ by regimens, except for bDRV regimens, which were consistently associated with smaller BMI increases than DTG. |
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This analysis sought to assess the association between ART regimens and changes in body mass index (BMI) among ART-experienced, virologically suppressed PLWH. ART-experienced, virologically suppressed PLWH ≥18 years of age in the Observational Pharmacoepidemiology Research and Analysis (OPERA) cohort were included for analysis if prescribed a new regimen containing one of the following core agents: dolutegravir (DTG), elvitegravir/cobicistat (EVG/c), raltegravir (RAL), rilpivirine (RPV), or boosted darunavir (bDRV), for the first time between August 1, 2013 and December 31, 2017. Multivariable linear regression was used to assess the association between regimen and mean changes in BMI at 6, 12, and 24 months after switch. In unadjusted analyses, BMI increases ranged from 0.30 kg/m2 (bDRV) to 0.83 kg/m2 (RPV) at 24 months following switch, but gains were observed with every regimen. In adjusted analyses, compared to DTG, only bDRV was associated with a smaller increase in BMI at all time points, while EVG/c and RAL were associated with smaller increases in BMI at 6 months only. Overall, results were consistent in analyses stratified by baseline BMI category. BMI increases were relatively small but followed an upward trend over time in this cohort of treatment-experienced, suppressed PLWH. Gains were attenuated with a longer period of follow-up. BMI gains did not differ by regimens, except for bDRV regimens, which were consistently associated with smaller BMI increases than DTG.</description><identifier>ISSN: 0889-2229</identifier><identifier>EISSN: 1931-8405</identifier><identifier>DOI: 10.1089/aid.2020.0287</identifier><language>eng</language><publisher>New Rochelle: Mary Ann Liebert, Inc</publisher><subject>AIDS/HIV ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Body mass ; Body mass index ; Body size ; Body weight gain ; HIV ; Human immunodeficiency virus</subject><ispartof>AIDS research and human retroviruses, 2021-11, Vol.37 (11), p.852-861</ispartof><rights>Copyright Mary Ann Liebert, Inc. 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In adjusted analyses, compared to DTG, only bDRV was associated with a smaller increase in BMI at all time points, while EVG/c and RAL were associated with smaller increases in BMI at 6 months only. Overall, results were consistent in analyses stratified by baseline BMI category. BMI increases were relatively small but followed an upward trend over time in this cohort of treatment-experienced, suppressed PLWH. Gains were attenuated with a longer period of follow-up. BMI gains did not differ by regimens, except for bDRV regimens, which were consistently associated with smaller BMI increases than DTG.</description><subject>AIDS/HIV</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Body weight gain</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><issn>0889-2229</issn><issn>1931-8405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpdkc1u2zAQhImgAeKmOeZOoJceKnf5I4k8ukbSGHDRIE5yFRhpZTOQSZWk0_iV-pSlmp56WmDn29kBhpBLBnMGSn8xtptz4DAHruoTMmNasEJJKN-RGSilC865PiPvY3wGAM15OSO_lzvjthipdfSr7470u4mRrlyHr3QRo2-tSdjRXzbt6MIlGzAF_2KDGegdbu0eHd1ksc3q3rstvQ9oUt6m4up1xGDRtdh9po82-MFvbWuG4Ug3h3EMGGM2vkU_DkjX9sXm679vblaPU5q0Q_rg7PR9k3KI-IGc9maIePFvnpOH66v75U2x_vFttVysi1aIOhVtZfpSAmM1lsiwl5WQJcgn3aNBzSQClxVTqsfeZIhVXRZ76Iw0okYO4px8evMdg_95wJiavY0tDoNx6A-x4SVXislaVxn9-B_67A_B5XSZ0qKqQdQ6U8Ub1QYfY8C-GYPdm3BsGDRTc01urpmaa6bmxB_XE44i</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Mounzer, Karam</creator><creator>Brunet, Laurence</creator><creator>Hsu, Ricky</creator><creator>Fusco, Jennifer</creator><creator>Vannappagari, Vani</creator><creator>Henegar, Cassidy</creator><creator>van Wyk, Jean</creator><creator>Crawford, Melissa</creator><creator>Lo, Janet</creator><creator>Fusco, Gregory</creator><general>Mary Ann Liebert, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8467-4835</orcidid><orcidid>https://orcid.org/0000-0003-1556-811X</orcidid></search><sort><creationdate>20211101</creationdate><title>Changes in Body Mass Index Associated with Antiretroviral Regimen Switch Among Treatment-Experienced, Virologically Suppressed People Living with HIV in the United States</title><author>Mounzer, Karam ; 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This analysis sought to assess the association between ART regimens and changes in body mass index (BMI) among ART-experienced, virologically suppressed PLWH. ART-experienced, virologically suppressed PLWH ≥18 years of age in the Observational Pharmacoepidemiology Research and Analysis (OPERA) cohort were included for analysis if prescribed a new regimen containing one of the following core agents: dolutegravir (DTG), elvitegravir/cobicistat (EVG/c), raltegravir (RAL), rilpivirine (RPV), or boosted darunavir (bDRV), for the first time between August 1, 2013 and December 31, 2017. Multivariable linear regression was used to assess the association between regimen and mean changes in BMI at 6, 12, and 24 months after switch. In unadjusted analyses, BMI increases ranged from 0.30 kg/m2 (bDRV) to 0.83 kg/m2 (RPV) at 24 months following switch, but gains were observed with every regimen. 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subjects | AIDS/HIV Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Body mass Body mass index Body size Body weight gain HIV Human immunodeficiency virus |
title | Changes in Body Mass Index Associated with Antiretroviral Regimen Switch Among Treatment-Experienced, Virologically Suppressed People Living with HIV in the United States |
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