Abstract
BackgroundWe performed a retrospective cohort study of treatment-naive patients with newly diagnosed HIV-infection enrolled at an urban university specialty clinic to identify whether INSTI-based ART regimens were associated with greater weight gain compared to NNRTI and PI based regimens in the first 12-18 months of treatment. The secondary aim of this study was to determine differences in weight gain between males and females within each of the three ART classesMethodsDifferences in weight change and BMI change were compared across ART class using nonparametric tests, specifically the Wilcoxon rank sum test. Nonparametric tests were also used to compare differences in weight change and BMI change between males and females within each ART class. Data were analyzed using R Core Team, 2020ResultsAmong the 348 individuals included in the study, 73% were African American and 79% were male and the median age was 32 years. There were 155 individuals initiating therapy on NNRTI based regimens (44%), 58 were on PI based regimens (17%) and 135 were on INSTI regimens (39%). The median weight at baseline was 170.5 lbs. and the median body mass index was 25.4 kg/m2. Median weight increased across all 3 ART regimens within the first 12-18 months of treatment. Median weight gain among the PI group was the greatest, at 6.8 lbs. (p= 0.04). Median weight gain among the NNRTI group was the lowest, .88 lbs (p=< .01). Median weight gain among those on INSTI based regimens was 4.8 lbs. (p= 0.11). Among those on INSTI-based regimens, women had a greater median increase in weight compared to men, 10.1 lbs. compared to 3.2 lbs., (p=0.046).ConclusionOverall, among individuals initiating HIV treatment those initiating PI based regimens experienced the most weight gain and individuals initiating INSTI based regimens did not experience a significant weight gain. Women on INSTI based regimens did experience a significant weight gain in comparison to men.. More research is needed to elucidate specific ART regimens’ causal role in weight gain and to identify risk factors for ART-associated weight gain.Disclosures All Authors: No reported disclosures
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