In patients with HIV infection, diet and combination antiretroviral therapy (ART) with tenofovir alafenamide (TAF) and an integrase strand transfer inhibitor were found to be significantly associated with weight gain, according to research presented at IDWeek, held virtually from September 29 to October 3, 2021.

Investigators analyzed data captured from adults with HIV infection who were evaluated at the Ohio State University Wexner Medical Center clinic between January 2015 and January 2019. All patients included in the analysis had received ART for at least 3 months. Patients who were pregnant and those with CD4+ T-cell counts of less than 200 cells/mm3, HIV viral loads of greater than200 copies/mL, or a history of malignancy were excluded. The primary outcome was weight change during the follow-up period, and the secondary outcome was the odds of a greater than 5-kg (11-lb) weight gain during the study period. In addition, the investigators used mixed effect linear and logistic regression analyses to determine the effect patients’ documented demographic and lifestyle factors, comorbidities, concurrent medications, and ART regimens had on these outcomes.

Of 870 patients included in the analysis, 83.6% were men, 29.2% were African American, and 65.6% had a BMI of greater than or equal to 25 kg/m2. During the mean follow-up period of 1.86 years, the mean percent change in weight was 2.12% ± 0.21% (P <.001), with an odds ratio (OR) of 0.293 for a greater than 5-kg (11-lb) weight gain (P <.001).


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The investigators found that male sex and increasing age were significantly associated with a decreased percent change in weight. Diet also was found to be significantly associated with a decreased percent change in weight (˗1.99% ± 0.47%; P <.001), as well as a decreased odds of a greater than 5-kg (11-lb) weight gain (OR, 0.70; 95% CI, 0.50-0.97; P =.03).

The investigators noted that “weight gain in [patients with HIV infection] is multifactorial.” In addition, “[these] data highlight the influential role of diet in [patients with HIV infection] at [increased] risk for ART-associated weight gain,” the investigators concluded.

Disclosure: One author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Patel Y, Doshi A, Levesque A, et al. Improvement in diet attenuates antiretroviral therapy (ART) associated weight gain in persons with human immunodeficiency virus (PWH). Presented at: IDWeek; September 29 to October 3, 2021. Poster 835.