Dolutegravir (DTG)-based regimen may lead to significant improvement in blood lipid concentration, and no interference on glucose metabolism, but a relevant increase in trunk fat without alterations of body mass index (BMI) and body fat percent among youth with HIV. The results of this research were presented at the virtual Conference on Retroviruses and Opportunistic Infections, held from March 8 to March 11, 2020.

Few studies exist on the role of DTG in the development of lipodystrophy and its effect on weight gain in adults. In this study, researchers investigated the effects of DTG on glico-lipidic metabolism and body composition among youths with HIV.

The study enrolled 14 patients (average age, 16.1 years; 12 girls) who were previously treated with a protease inhibitor (PI) or nucleoside reverse-transcriptase inhibitor (NRTI) and switched ABC/3TC/DTG regimen. Blood glucose concentration, total and fractionated triglyceride and cholesterol were measured at baseline and at 3, 6 and 12 months. Body composition and BMI were evaluated and calculated at baseline and after 12 months. For repeated measures, statistical comparisons were performed by ANOVA.

The results revealed that there was no significant chance during the follow-up for mean blood concentration and high-density lipoprotein cholesterol. The mean total cholesterol concentration was 190, 159, 161 and 168 mg/dL at baseline, 3, 6 and 12 months, respectively (P =.0057). Similarly, mean low-density lipoprotein concentration demonstrated no significant change, with values of 109, 90, 92 and 96 mg/dL at baseline, 3, 6 and 12 months (P =.025). 

However, triglyceride concentration decreased significantly after 3 months of therapy (114 and 64 mg/dL; P =.007). BMI also remained consistent, with measurements of 20.4 at baseline and 20.9 kg/m2 after 12 months (P =.09). Further, although body fat percentage did not change significantly during the study (P =.16), a significant increase in trunk body fat perfect was observed (P =.0413). Specifically, trunk/total body less head fat ratio was significantly increased (P =.0485), however, limbs/trunk fat ratios were significantly decreased (P =.0495).

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Limitations of the study included a small sample size and lack of generalizability to men given that the sample cohort was predominantly composed of women (12 of 14 patients).

Further research, with a larger sample size is needed to fully elucidate the role of DTG in lipodystrophy development and its impact on weight gain in adults.

References

Giacomet V, Lazzarin S, Manzo A, Longoni E, Maruca K, Erba P, et al. Body fat and lipid profile changes in HIV-infected youths switched to dolutegravir. Poster presented at: CROI 2020. March 8-11, 2020. http://www.croiconference.org/sites/default/files/uploads/croi2020-boston-abstract-ebook.pdf. Accessed March 19, 2020.