- Dolutegravir (DTG), the preferred antiretroviral therapy (ART) for HIV, is associated with weight increases, according to results from the ADVANCE and NAMSAL trials.
Why this matters
- DTG has been associated with weight increases and clinical obesity, more so in black people and women.
- WHO has just recommended dolutegravir as a first-line treatment.
- In 96-week NAMSAL trial, 613 treatment-naive patients in Cameroon were randomly allocated to tenofovir disoproxil fumarate (TDF)/lamivudine/DTG or TDF/lamivudine/efavirenz (EFV).
- In the 96-week ADVANCE trial, 1053 treatment-naive patients in South Africa were randomly allocated to tenofovir alafenamide (TAF)/emtricitabine/DTG, TDF/emtricitabine/DTG, or TDF/emtricitabine/EFV.
- Both trials measured changes in body weight and BMI between treatment arms; ADVANCE also compared trunk fat.
- First-line DTG with TDF/lamivudine was associated with weight increases and clinical obesity (ADVANCE and NAMSAL).
- Increased trunk and limb fat was associated with TAF/emtricitabine (ADVANCE).
- Women experienced steeper weight increases and continuous progression of weight gain with DTG plus TAF/emtricitabine or TDF/emtricitabine (ADVANCE).
- Not all participants had reached 96 weeks of follow-up.
- Results are from a preliminary analysis of a still-enrolling study and were presented without peer review at a conference.