Hormonal
Integrase Strand Transfer Inhibitors (INSTIs), specifically Dolutegravir (DTG) and Bictegravir (BIC), are associated with significant weight gain compared to older antiretrovirals like Efavirenz (EFV) or Protease Inhibitors.
If you are starting HIV treatment, ask your doctor about INSTIs (like Dolutegravir). They are effective but may cause weight gain, especially in women and Black individuals. If weight gain is a major concern, discuss alternatives like TDF-based regimens or older agents like Efavirenz, though these may have other side effects.
Specifically, INSTIs were associated with more weight gain compared to non-nucleoside/nucleotide reverse transcriptase inhibitors (NNRTIs) and PIs, while bictegravir (BIC) and DTG were associated with more weight gain compared to elvitegravir/cobicistat (EVG/c).
Why this rating
Supported by multiple randomized trials (ADVANCE, NAMSAL) and meta-analyses.
Source
Beyond the Numbers: Weight Gain Risk Factors, Implications, and Interventions among Individuals with HIV
Yesha Patel et al. · Journal of AIDS and HIV Treatment · 2024
DOI 10.33696/aids.6.047
More from this paper
- Switching from Tenofovir Alafenamide (TAF) to Tenofovir Disoproxil Fumarate (TDF) in women with HIV results in significant weight loss, indicating TDF has weight-suppressive effects.Good
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide and tirzepatide are effective for weight loss in people with HIV, with tirzepatide showing the largest mean percent change in weight.Good
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