A retrospective cohort study on the potential link between dolutegravir-based anti-retroviral therapy and weight gain compared to efavirenz-based anti-retroviral therapy in a tertiary care center in Jabalpur, Madhya Pradesh
Amal C Anil, Sanjay Gedam, Gargi Sethi, Namita Parashar, Namita Barmaiya, Aryasree L, Shivank Sethi.
Abstract
Background: Anti-retroviral therapies (ARTs) for human immunodeficiency virus (HIV) such as dolutegravir (DTG) and efavirenz have been associated with weight gain. Comparing the weight trajectories of the tenofovir/lamivudine/dolutegravir (TLD) and tenofovir/lamivudine/efavirenz (TLE) regimens can give insights into their differential metabolic impact.
Aims and Objectives: The aim of the study was to analyze and compare weight changes in HIV patients on TLE versus TLD regimens over 6 months at a tertiary health center in Jabalpur.
Materials and Methods: This was a retrospective cohort study of 200 HIV patients (100 each on TLE and TLD regimens) from January 2018 to December 2022. Weight change over three prescription time points was recorded. Patients included if >20 years old, on ART >4 weeks, and adherent. Patients excluded if pregnant, comorbidities present, or on ART 5% weight gain versus 33% of TLE patients. Analysis of variance showed no significant difference in TLE weight over time (P = 0.864) but a significant TLD weight gain (P = 0.034).
Conclusion: HIV patients on DTG-containing TLD regimen demonstrated a substantial weight gain, whereas TLE regimen patients saw insignificant change. Over half of the TLD patients experienced a concerning >5% weight increase indicating an unfavorable metabolic impact. Health-care providers need awareness of weight gain linked to these HIV drugs to optimize treatment regimens.
Key words: Human Immunodeficiency Virus, Anti-retroviral Therapy, Dolutegravir, Efavirenz, Tenofovir/Lamivudine/Dolutegravir, Tenofovir/Lamivudine/Efavirenz, Weight Gain
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