Factors Associated With Weight Gain in People Treated With Dolutegravir

Abstract

An unexpected excess in weight gain has recently been reported in course of dolutegravir (DTG) treatment. Aim of the present study is to investigate whether weight gain differs among different DTG-containing regimens. Adult naïve and experienced people with HIV (PWH) initiating DTG–based ART between July 2014 and December 2019 in SCOLTA prospective cohort (Surveillance Cohort Long-Term Toxicity Antiretrovirals) were included. We used an adjusted general linear model to compare weight change among backbone groups, and a Cox proportional hazard regression model to calculate hazard ratios (HR) and 95%CI for weight increase >10% from baseline. A total of 713 participants, 25.3% women, 91% Caucasian were included. Of them, 195 (27.4%) started DTG as first ART regimen, while 518 (72.6%) were ART-experienced. DTG was associated with abacavir/lamivudine in 326 participants, tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in 148, boosted protease inhibitors in 60, rilpivirine in 45, lamivudine in 75 and tenofovir alafenamide (TAF)/FTC in 59. At six and twelve months, weight gain was highest among PWH on TDF/FTC+DTG and TAF/FTC+DTG. Baseline CD4 10% from baseline. Higher weight (HR 0.97 by one kg, 95%CI 0.96-0.99) and female gender (HR 0.54, 95%CI 0.33-0.88) resulted protective. Naïve PWH with lower CD4 counts and those on TAF/FTC or TDF/FTC backbones resulted at higher risk of weight increase in course of DTG-based ART.