Abstract
BackgroundGlobal antiretroviral therapy has entered a new era. Integrase strand transfer inhibitor (INSTI) has become the first choice in acquired immunodeficiency syndrome (AIDS) treatment. Because INSTI has high antiviral efficacy, rapid virus inhibition, and good tolerance. However, INSTIs may increase the risk of obesity. Each INSTI has its unique impact on weight gain in patients with human immunodeficiency virus (HIV)/AIDS. This study systematically assessed different INSTIs in causing significant weight gain in HIV/AIDS patients by integrating data from relevant literature.MethodsPubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP), and Wanfang databases were searched to find studies on the influence of different INSTIs in weight gain. Data on weight change were extracted, and a network meta-analysis was performed.ResultsEight studies reported weight changes in HIV/AIDS patients were included. Results of the network meta-analysis showed that the weight gain of HIV/AIDS patients treated with Dolutegravir (DTG) was significantly higher than that of Elvitegravir (EVG) [MD = 1.13, (0.18–2.07)]. The consistency test results showed no overall and local inconsistency, and no significant difference in the results of the direct and indirect comparison was detected (p > 0.05). The rank order of probability was DTG (79.2%) > Bictegravir (BIC) (77.9%) > Raltegravir (RAL) (33.2%) > EVG (9.7%), suggesting that DTG may be the INSTI drug that causes the most significant weight gain in HIV/AIDS patients.ConclusionAccording to the data analysis, among the existing INSTIs, DTG may be the drug that causes the most significant weight gain in HIV/AIDS patients, followed by BIC.
Highlights
Global antiretroviral therapy has entered a new era
Obesity may impact the health of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients as obesity may lead to the occurrence of non-AIDS-related comorbidities [15, 22, 24, 25]
This study found that DTG may be the drug that causes the most significant weight gain in HIV/AIDS patients
Summary
Integrase strand transfer inhibitor (INSTI) has become the first choice in acquired immunodeficiency syndrome (AIDS) treatment. Each INSTI has its unique impact on weight gain in patients with human immunodeficiency virus (HIV)/AIDS. This study systematically assessed different INSTIs in causing significant weight gain in HIV/AIDS patients by integrating data from relevant literature. Integrase strand transfer inhibitors (INSTI), a new class of antiviral drugs, includes Dolutegravir (DTG), Raltegravir (RAL), Elvitegravir (EVG), and Bictegravir (BIC), have good efficacy and tolerability [6,7,8]. Some studies [22, 23] found that more than half of the HIV/ AIDS patients who received ART for up to 3 years were overweight or obese, and the potential impacts of weight gain in HIV/AIDS patients are not clear. Obesity may impact the health of HIV/AIDS patients as obesity may lead to the occurrence of non-AIDS-related comorbidities [15, 22, 24, 25]
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