Weight Gain Associated With Integrase Stand Transfer Inhibitor Use in Women
Weight Gain Associated With Integrase Stand Transfer Inhibitor Use in Women
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DOI：
10.1093/cid/ciz853
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发表时间：
2020-08-01
影响因子：
11.8
通讯作者：
Lahiri, Cecile D.
中科院分区：
文献类型：
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作者：
Kerchberger, Anne Marie;Sheth, Anandi N.;Lahiri, Cecile D.
背景基于整合酶链转移抑制剂（Integrase strand-transfer inhibitor，ART）的抗逆转录病毒治疗（antiretroviral therapy，ART）被推荐用于人类免疫缺陷病毒（human immunodeficiency virus，HIV）的管理。虽然研究表明INSTI与体重增加之间存在关联，但研究中感染艾滋病毒的妇女人数不足。我们评估了在WLHIV中切换或添加INSTI的效果。从2006年至2017年参加妇女机构间艾滋病毒研究（WIHS）的妇女转向或增加了抗逆转录病毒治疗（SWAD组），与非抗逆转录病毒治疗（STAY组）的妇女进行了比较。在SWAD参与者中，在SWAI转换/添加前6-12个月和转换/添加后6-18个月测量体重、体重指数（BMI）、体脂百分比（PBF）以及腰围、臀围、臂围和大腿围，STAY参与者中的测量时间点具有可比性。线性回归模型比较了SWAD/STAY组随时间的变化，调整了年龄，种族，WIHS网站，教育，收入，吸烟状况和基线ART方案。我们对1118名女性（234名SWAD和884名STAY）进行了平均2.0年的随访（+/- 0.1标准差[SD];平均年龄48.8岁，SD +/- 8.8）; 61%为黑人。平均而言，与STAY组相比，SWAD组的体重平均增加了2.1 kg，BMI增加了0.8 kg/m2，PBF增加了1.4%，腰围、臀围、臂围和大腿围分别增加了2.0、1.9、0.6和1.0 cm（所有P值均<0.05）。这些变化的幅度无差异，观察到的ECOI型。结论。在WLHIV中，与非抗逆转录病毒治疗相比，转为抗逆转录病毒治疗与体重、腰围和脂肪百分比的显著增加相关。这些变化对代谢和其他健康的影响值得进一步研究。
Background. Integrase strand-transfer inhibitor (INSTI)-based antiretroviral therapy (ART) is recommended for human immunodeficiency virus (HIV) management. Although studies have suggested associations between INSTIs and weight gain, women living with HIV (WLHIV) have been underrepresented in research. We evaluated the effect of switching or adding INSTIs among WLHIV.Methods. Women enrolled in the Women's Interagency HIV Study (WIHS) from 2006-2017 who switched to or added an INSTI to ART (SWAD group) were compared to women on non-INSTI ART (STAY group). Body weight, body mass index (BMI), percentage body fat (PBF), and waist, hip, arm, and thigh circumferences were measured 6-12 months before and 6-18 months after the INSTI switch/add in SWAD participants, with comparable measurement time points in STAY participants. Linear regression models compared changes over time by SWAD/STAY group, adjusted for age, race, WIHS site, education, income, smoking status, and baseline ART regimen.Results. We followed 1118 women (234 SWAD and 884 STAY) for a mean of 2.0 years (+/- 0.1 standard deviation [SD]; mean age 48.8 years, SD +/- 8.8); 61% were Black. On average, compared to the STAY group, the SWAD group experienced mean greater increases of 2.1 kg in body weight, 0.8 kg/m(2) in BMI, 1.4% in PBF, and 2.0, 1.9, 0.6, and 1.0 cm in waist, hip, arm, and thigh circumference, respectively (all P values < .05). No differences in magnitudes of these changes were observed by INSTI type.Conclusions. In WLHIV, a switch to INSTI was associated with significant increases in body weight, body circumferences, and fat percentages, compared to non-INSTI ART. The metabolic and other health effects of these changes deserve further investigation.