Selected Sections From the DHHS Guidelines: Weight Gain
Greater weight gain has been associated with initiation of INSTI-containing regimens in ARV-naïve individuals than with boosted-PI regimens or NNRTIs
- The mean increase in weight associated with BIC and DTG was similar and greater than with EVG/c or EFV
- Greater weight gain has also been observed after initiation of TAF or with a switch from TDF to TAF, especially in conjunction with INSTIs
ARV-associated weight gain should be a pretreatment consideration
INSTI-related weight gain appears to disproportionately affect women and Black and Hispanic people
- Black women showed the greatest increase in weight gain
- Predictors and mechanism(s) for the weight gain are still unclear
The long-term consequences and reversibility of weight gain in ART remain unknown
- Regional distribution of weight gain, whether the weight gain is associated with significant cardiometabolic risk or whether it is reversible upon discontinuation of the offending agent, are questions that require further clarification
ART=antiretroviral therapy; ARV=antiretroviral; BIC=bictegravir; DHHS=Department of Health and Human Services; DTG=dolutegravir; EFV=efavirenz; EVG/c=elvitegravir/cobicistat; INSTl=integrase strand transfer inhibitor; NNRTI=non-nucleoside reverse transcriptase inhibitor; Pl=protease inhibitor; TAF=tenofovir alafenamide; TDF=tenofovir disoproxil fumarate.
Reference: Department of Health and Human Services Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Updated January 20, 2022. Accessed March 8, 2022. https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv/whats-new-guidelines
