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Energy balance and body composition after switch between integrase strand transfer inhibitors and doravirine among people with HIV
Ist Teil von
Journal of antimicrobial chemotherapy, 2024-01, Vol.79 (1), p.179-185
Ort / Verlag
US: Oxford University Press
Erscheinungsjahr
2024
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
Abstract
Background
Integrase strand transfer inhibitors (INSTIs) are associated with excessive weight gain among a subset of persons with HIV (PWH), due to unclear mechanisms. We assessed energy intake (EI) and expenditure (EE) following switch off and onto INSTIs.
Methods
PWH with >10% weight gain on an INSTI-based regimen switched INSTI to doravirine for 12 weeks, then back to INSTI for 12 weeks while keeping their remaining regimen stable. Twenty-four-hour EE, EI and weight were measured on INSTI, following switch to doravirine, and upon INSTI restart. Mixed models analysed changes over time.
Results
Among 18 participants, unadjusted 24 h EE decreased by 83 (95% CI −181 to 14) kcal following switch to doravirine, and by 2 (−105 to 100) kcal after INSTI restart; energy balance (EE−EI) increased by 266 (−126 to 658) kcal from Week 0 to Week 12, and decreased by 3 (−429 to 423) kcal from Week 12 to Week 24. Trends toward weight loss occurred following switch to doravirine [mean −1.25 (−3.18 to 0.69) kg] and when back on INSTI [−0.47 (−2.45 to 1.52) kg]. Trunk fat decreased on doravirine [−474 (−1398 to 449) g], with some regain following INSTI restart [199 (−747 to 1145) g]. Fat-free mass decreased on doravirine [−491 (−1399 to 417) g] and increased slightly after INSTI restart [178 (−753 to 1108) g].
Conclusions
Among PWH with >10% weight gain on an INSTI, switch to doravirine was associated with a trend towards decreases in 24 h EE, weight, trunk fat mass and fat-free mass. Observed changes were not significant, but suggest a mild weight-suppressive effect of doravirine among PWH.