Hormonal
Integrase strand transfer inhibitors (INSTIs), particularly dolutegravir and bictegravir, cause significant weight gain and treatment-emergent obesity in people living with HIV, with effects most pronounced in women and Black individuals.
If you are living with HIV and starting or switching to an INSTI-based regimen (like dolutegravir or bictegravir), be aware that significant weight gain is a known side effect, especially if you are a woman or Black. Monitor your weight closely. If you experience excessive gain, discuss switching to a regimen with a lower weight gain profile (like one using TDF instead of TAF) with your provider.
accumulating evidence suggests that therapies including new generation integrase strand transfer inhibitors (INSTIs) cause more weight gain and treatment-emergent obesity than other ART regimens... The statistically significant increases in body weight and clinical obesity with INSTIs appear to be most pronounced in Black individuals and women
Why this rating
Supported by multiple randomized studies and large cohort studies (NA-ACCORD, Women’s Interagency HIV Study), though the paper notes some inconsistency and need for more RCTs.
Source
HIV Treatment and Obesity: What’s New?
Paula Freitas et al. · Infectious diseases · 2023
DOI 10.5772/intechopen.112667
More from this paper
- Orlistat is generally not recommended for people living with HIV on combined antiretroviral therapy (cART) due to the risk of reduced absorption of antiretroviral drugs and subsequent loss of viral control.Moderate
- GLP-1 receptor agonists (Liraglutide, Semaglutide) and dual agonists (Tirzepatide) are viable and promising options for weight loss in people living with HIV, with minimal drug-drug interaction risks compared to Orlistat.Moderate
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