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Michelle Moorhouse, MB BCh, from Wits Reproductive Health and HIVInstitute, like many other physicians, started to notice that the numbers on the scale kept going up for her patients who were taking integrase inhibitors. Speaking from the podium here at the International AIDS Society (IAS) 2019 Conference on HIV Science, Moorhouse explained that "a real flurry" of reports started coming in about tenofovir alafenamide and dolutegravir being associated with weight gain.
Dolutegravir and tenofovir alafenamide can lead to weight gain, especially in women, according to new data that are changing the way researchers look at their study populations. So the ADVANCE team worked with researchers from the New Antiretroviral and Monitoring Strategies in HIV Infected Adults in Low-income countries (NAMSAL) trial NCT02777229) to pull together all the weight-gain data accrued from their combined cohort of 1666 participants. And they found a consistent story.
In the NAMSAL trial, weight gain was higher in the dolutegravir group than in the efavirenz group (5 kg vs 3 kg; P ≤ .001), and the mean increase in body mass index was greater in the dolutegravir group (1.7 vs 1.2 kg/m2; P ≤ .001). In the ADVANCE trial, weight gain was even more pronounced, but the pattern was the same: participants in the dolutegravir plus Descovy group gained more weight over 96 weeks than those in the dolutegravir plus Truvada group (8 kg vs 5 kg).
