Transition to Dolutegravir Is Associated With an Increase in the Rate of Body Mass Index Change in a Cohort of Virally Suppressed Adolescents.
Transition to Dolutegravir Is Associated With an Increase in the Rate of Body Mass Index Change in a Cohort of Virally Suppressed Adolescents.
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DOI：
10.1093/cid/ciaa1652
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发表时间：
2021-08-02
期刊：
影响因子：
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通讯作者：
Kay AW
中科院分区：
文献类型：
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作者：
Thivalapill N;Simelane T;Mthethwa N;Dlamini S;Lukhele B;Okello V;Kirchner HL;Mandalakas AM;Kay AW
含有dolutegravir（DTG）的抗逆转录病毒治疗（ART）方案与成人体重指数（BMI）增加有关。然而，这种关系在青少年中没有得到很好的描述。在斯威士兰的一个临床研究中心，对460名病毒抑制（<200拷贝/mL）的人类免疫缺陷病毒感染青少年进行了回顾性观察队列研究，分析了DTG转换前1年至DTG转换后1年的体重指数（BMI）测量值。随机效应线性样条模型用于描述过渡到DTG之前和之后BMI的变化率。在青少年中，DTG转换前BMI以每年0.3 kg/m2的速率增加，DTG转换后BMI以每年1.2 kg/m2的速率增加。青少年的性别改变了DTG和BMI变化率之间的关系：DTG转换后的BMI变化率女性每年增加1.1 kg/m2，男性每年增加0.6 kg/m2。病毒抑制青少年（10-19岁）过渡到DTG与BMI变化率增加相关。女性青少年可能比男性经历更大的变化。需要进一步的研究来阐明这些观察结果的机制，并评估DTG如何影响青少年在较长时间的治疗后的BMI。Dolutegravir与成人体重增加有关。在这组病毒抑制的人类免疫缺陷病毒感染青少年中，过渡到度鲁特韦与体重指数增加速度加快相关。这种影响在女性青少年中最为明显。
Antiretroviral therapy (ART) regimens that contain dolutegravir (DTG) have been associated with increases in body mass index (BMI) in adults. However, this relationship has not been well described in adolescents. In a retrospective observational cohort of 460 virally suppressed (<200 copies/mL) adolescents living with human immunodeficiency virus at a clinical site in Eswatini, body mass index (BMI) measurements were analyzed between 1 year prior to the transition to DTG and up to 1 year after DTG transition. Random-effects linear spline models were used to describe the rate of change in BMI before and after the transition to DTG. In adolescents, BMI increased at a rate of 0.3 kg/m2 per year before DTG transition and increased to a rate of 1.2 kg/m2 per year after DTG transition. Sex of the adolescent modified the relationship between DTG and rate of BMI change: BMI rate of change after DTG transition was increased by 1.1 kg/m2 in females and 0.6 kg/m2 per year in males. Transition to DTG in virally suppressed adolescents (aged 10–19 years) is associated with an increase in the rate of BMI change. Female adolescents may experience a larger change than males. Further investigation is required to elucidate the mechanism that underlies these observations and to assess how DTG impacts BMI in adolescents following longer durations of treatment. Dolutegravir has been associated with weight gain in adults. In this cohort of virally suppressed adolescents living with Human Immunodeficiency Virus, transition to dolutegravir was associated with an accelerated rate of body mass index increase. The effect was most pronounced in female adolescents.