Limited weight impact after switching from boosted protease ihibitors to dolutegravir in persons with human immunodeficiency virus with high cardiovascular risk: a post hoc analysis of the 96-week NEAT-022 randomized trial

NEAT 022 Study Grp

    Research output: Contribution to journalA1: Web of Science-articlepeer-review

    Abstract

    Background 

    In the NEAT022 trial, virologically suppressed persons with human immunodeficiency virus (HIV) at high cardiovascular risk switching from protease inhibitors to dolutegravir either immediately (DTG-I) or after 48 weeks (DTG-D) showed noninferior virological suppression and significant lipid and cardiovascular disease risk reductions on switching to dolutegravir relative to continuing protease inhibitors. 

    Methods 

    In post hoc analysis, major endpoints were 48-week and 96-week weight and body mass index (BMI) changes. Factors associated with weight/BMI changes within the first 48 weeks of DTG exposure, proportion of participants by category of percentage weight change, proportions of BMI categories over time, and impact on metabolic outcomes were also assessed. 

    Results 

    Between May 2014 and November 2015, 204 (DTG-I) and 208 (DTG-D) participants were included. Weight significantly increased (mean, +0.810 kg DTG-I arm, and +0.979 kg DTG-D arm) in the first 48 weeks postswitch, but remained stable from 48 to 96 weeks in DTG-I arm. Switching from darunavir, White race, total to high-density lipoprotein cholesterol ratio = 5% weight change increased similarly in both arms over time. The proportions of BMI categories, use of lipid-lowering drugs, diabetes and/or use of antidiabetic agents, and hypertension and/or use of antihypertensive agents did not change within or between arms at 48 and 96 weeks. 

    Conclusions 

    Switching from protease inhibitors to dolutegravir in persons with HIV with high cardiovascular risk led to modest weight gain limited to the first 48 weeks, which involved preferentially normal-weight or underweight persons and was not associated with negative metabolic outcomes.

    Switching from protease inhibitors to dolutegravir in persons with HIV with high cardiovascular risk led to modest weight gain limited to the first 48 weeks, which involved preferentially normal-weight or underweight persons and was not associated with negative metabolic outcomes.

    Original languageEnglish
    Article numberciac827
    JournalClinical Infectious Diseases
    Volume76
    Issue number5
    Pages (from-to)861-870
    Number of pages10
    ISSN1058-4838
    DOIs
    Publication statusE-pub ahead of print - 2022

    Keywords

    • weight
    • switch
    • dolutegravir
    • TENOFOVIR DISOPROXIL FUMARATE
    • BODY-MASS
    • GAIN
    • RITONAVIR
    • RALTEGRAVIR
    • ATAZANAVIR

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