Recent studies have highlighted a significant weight increase in HIV infected patients who began antiretroviral drugs (ART), particularly doultegravir (DTG). Aim of the present study was to evaluate predictors of weight gain in DTG treated patients in SCOLTA (Surveillance Cohort Long-Term Toxicity Antiretrovirals) cohort. Method: We analyzed data from SCOLTA prospective database. All patients initiating DTG and for whom weight was registered were considered. We defined as gainers those patients whose weight increased by at least 7% from baseline. Ninety-one patients with weight gain ranging from 1% to < 7% were excluded. Non gainers were those whose weight increased < 1% or decreased. The multivariable analysis was performed by logistical regression, with gainer y/n as the dependent variable, including baseline weight, age, sex, CDC stage, ART, years of previous ART, naïve/experienced, HCV treatment and statin use. Results:A total of 503 patients were analyzed: DTG was associated with abacavir/lamivudine (ABC/3TC) in 276 patients (54.9%), tenofovir/emtricitabine (TDF/FTC) in 128 (25.4%), darunavir/ritonavir or cobicistat in 29 (5.8%), rilpivirine in 24 (4.8%), 3TC in 34 (6.8%) and tenofovir alafenamide (TAF)/FTC in 12 (2.4%). Among them, 503 and 393 patients reached 6 and 12 months follow-up. Eighty-one subjects (16.1%) were gainers (Table 1). , 95%CI 1.01-4.13), TDF/FTC as compared to 3TC/ABC (OR 2.57, 95%CI 1.42-4.65), CD4 count (OR for cell/mL >500 vs < 200 0.50, 95% CI 0.25- 0.99), statin use (OR 2.43, 95% CI 1.06-5.05) and successful HCV treatment (OR 6.63, 95% CI 2.08-21.13). Conclusion:In SCOLTA the use of TDF/FTC resulted as independent factor associated with weight gain in PLWHIV treated with DTG. Male patients with lower baseline weight and lower CD4 were those more prone to gain weight. No Gainers Gainers All p N=422 83.9% N=81 16.1% N=503 100% Male Sex N=310 73.5% N=64 79.0% N=374 74.0% 0.29 Age, years (mean ± SD) 47.43±11.7 46.0±12.0 47.1±11.7 0.36 Weight, Kg (mean±SD) 71.2±13.3 67.4±15.4 70.6±13.7 0.02 CD4, cells/mmc (mean ± SD) 594±360 440±370 570±365 0.0006 Naive Status N=96 22.7% N=29 35.8% N=125 24.9% 0.013 Active HCV infection (baseline) N=32 7.6% N=13 16.0% N=45 9.0% 0.014 HCV eradication during follow-up (N=45) N=8 25% N=7 53.8% N=15 33.3% 0.06 Statin use at baseline N=34 8.1% N=8 9.9% N=42 8.3% 0.58 [Table 1. Characteristics of patients in SCOLTA DTG cohort, according to weight gain status.]
SLAM Project - Second-Level Diagnostic Assessment: Multidisciplinary approach to HIV Patients
De Socio G;
2019
Abstract
Recent studies have highlighted a significant weight increase in HIV infected patients who began antiretroviral drugs (ART), particularly doultegravir (DTG). Aim of the present study was to evaluate predictors of weight gain in DTG treated patients in SCOLTA (Surveillance Cohort Long-Term Toxicity Antiretrovirals) cohort. Method: We analyzed data from SCOLTA prospective database. All patients initiating DTG and for whom weight was registered were considered. We defined as gainers those patients whose weight increased by at least 7% from baseline. Ninety-one patients with weight gain ranging from 1% to < 7% were excluded. Non gainers were those whose weight increased < 1% or decreased. The multivariable analysis was performed by logistical regression, with gainer y/n as the dependent variable, including baseline weight, age, sex, CDC stage, ART, years of previous ART, naïve/experienced, HCV treatment and statin use. Results:A total of 503 patients were analyzed: DTG was associated with abacavir/lamivudine (ABC/3TC) in 276 patients (54.9%), tenofovir/emtricitabine (TDF/FTC) in 128 (25.4%), darunavir/ritonavir or cobicistat in 29 (5.8%), rilpivirine in 24 (4.8%), 3TC in 34 (6.8%) and tenofovir alafenamide (TAF)/FTC in 12 (2.4%). Among them, 503 and 393 patients reached 6 and 12 months follow-up. Eighty-one subjects (16.1%) were gainers (Table 1). , 95%CI 1.01-4.13), TDF/FTC as compared to 3TC/ABC (OR 2.57, 95%CI 1.42-4.65), CD4 count (OR for cell/mL >500 vs < 200 0.50, 95% CI 0.25- 0.99), statin use (OR 2.43, 95% CI 1.06-5.05) and successful HCV treatment (OR 6.63, 95% CI 2.08-21.13). Conclusion:In SCOLTA the use of TDF/FTC resulted as independent factor associated with weight gain in PLWHIV treated with DTG. Male patients with lower baseline weight and lower CD4 were those more prone to gain weight. No Gainers Gainers All p N=422 83.9% N=81 16.1% N=503 100% Male Sex N=310 73.5% N=64 79.0% N=374 74.0% 0.29 Age, years (mean ± SD) 47.43±11.7 46.0±12.0 47.1±11.7 0.36 Weight, Kg (mean±SD) 71.2±13.3 67.4±15.4 70.6±13.7 0.02 CD4, cells/mmc (mean ± SD) 594±360 440±370 570±365 0.0006 Naive Status N=96 22.7% N=29 35.8% N=125 24.9% 0.013 Active HCV infection (baseline) N=32 7.6% N=13 16.0% N=45 9.0% 0.014 HCV eradication during follow-up (N=45) N=8 25% N=7 53.8% N=15 33.3% 0.06 Statin use at baseline N=34 8.1% N=8 9.9% N=42 8.3% 0.58 [Table 1. Characteristics of patients in SCOLTA DTG cohort, according to weight gain status.]I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
