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Women - greater weight gain than men associated with integrase inhibitors - all future ART studies should include looks at weight gain.
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comments below on women & weight gain selected from each study along with links to full study
At CROI 2019 there were a bunch of presentations and discussions about weight gain associated with integrase inhibitors. Here are those studies, finding women experienced greater weight gain than men inmost of the studies. one study did not find weight gain associated with integrase but the others did. One study found increased risk associated with weight gain for comorbid conditions body fat, blood pressure, new onset diabetes.One study found weight gain with integrase associated with bad affects on immune activation markers related to perhaps increased risk for comorbidities like heart disease but this is yet to be confirmed as longer studies and evaluating outcomes of these affects have not been conducted. One study found greater weight in PLWH >60. John Koethe delivered an overview and commentary and perspective in a plenary talk:
PLENARY TALK - Obesity & Weight Gain on Antiretroviral Therapy - (03/11/19)
Integrase Strand Transfer Inhibitors are Associated With Weight Gain in Women - (03/25/19)
In a longitudinal study of HIV+ women on ART, a switch to INSTI was associated with significant increases in body weight and measurements, body fat, and blood pressure compared to those remaining on non-INSTI ART. Further research is urgently needed for prevention and management of metabolic effects with INSTI use. New-onset DM occurred in 4.5% (n=8) in SWAD and 2.2% (n=15) in STAY, p=0.11. No significant differences in outcomes were observed by INSTI type.
DIFFERENTIAL BMI CHANGES FOLLOWING PI- AND INSTI- BASED ART INITIATION BY SEX AND RACE - (03/13/19)
RISK FACTORS FOR EXCESS WEIGHT GAIN FOLLOWING SWITCH TO INTEGRASE INHIBITOR-BASED ART - (03/11/19)
one study did not find weight gain with integrase
Weight Gain During Treatment Among 3,468 Treatment-Experienced Adults with HIV - (03/11/19)
Weight Gain among Virally Suppressed Persons who Switch to INSTI-Based ART, The HIV Outpatient Study - (03/11/19)
The Impact of Weight Gain and Sex on Immune Activation Following Initiation of ART - (03/11/19)
You will note that, among women (but not men), gaining weight was significantly associated with smaller decreases in sCD163 compared to women maintaining weight.
Pharmacogenetics of Weight Gain after Switch from Efavirenz to Integrase Inhibitors - (03/11/19)
GREATER WEIGHT GAIN AMONG TREATMENT-NAIVE PERSONS STARTING INTEGRASE INHIBITORS - (03/11/19)
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