Weight gain in patients starting Dolutegravir-based ART according to baseline CD4 count after 48 weeks of follow up.

Abstract

Excessive weight gain is a current concern among People Living with HIV (PLHIV) starting ART. To evaluate the weight gain after 48-weeks of ART in naive patients, according with baseline CD4 count. PLHIV starting 3TC+TDF+DTG with at least 48-weeks of follow up in two AIDS referral centers were stratified by baseline CD4 count (lower or higher than 200 cells/mm3). Data on CD4 count, HIV viral load, weight/Body Mass Index (BMI), lipids and glucose levels were collected at baseline, 24 and 48 weeks of treatment. For analysis purpose, patients were categorized according to their BMI progression. A total of 270 patients were included in the study. Mean CD4 count were 78.3±61.7 and 536.7±273 cells/mm3 for low and high CD4 count groups, respectively (p < 0.001). Baseline BMI was significantly lower in low CD4 group (21.7vs. 23.6 Kg/m2, p < 0.001). Patients in low CD4 group gained more weight than those in high CD4 group (11.2±8.5kg vs. 2.2±4.2 Kg, p=0.004). Overall weight gain was higher in women, regardless group (13.1±7.9 Kg vs. 1.4±3.6 Kg for women and men, respectively, p < 0.001). The proportion of overweight/obesity significantly increased in low CD4 group. Viral suppression rate was high for both groups. At week 48 the overall proportion of overweight/obesity was like that reported for the Brazilian population. Weight gain in the present study indicates a "return to health" phenomenon. Excessive weight gain was more frequent in women.