1. Obesity Modifies the Relationship Between Raltegravir and Dolutegravir Hair Concentrations and Body Weight Gain in Women Living with HIV.
- Author
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Lahiri, Cecile D., Mehta, C. Christina, Sykes, Craig, Weiser, Sheri D., Palella, Frank, Lake, Jordan E., Mellors, John W., Gustafson, Deborah, French, Audrey L., Adimora, Adaora A., Konkle-Parker, Deborah, Sharma, Anjali, Bolivar, Hector, Kassaye, Seble G., Rubin, Leah H., Alvarez, Jessica A., Golub, Elizabeth T., Ofotokun, Igho, and Sheth, Anandi N.
- Abstract
Integrase strand-transfer inhibitors (INSTIs) are associated with weight gain in women living with HIV (WLH). Relationships between drug exposure, baseline obesity, and INSTI-associated weight gain remain unclear. Data from 2006 to 2016 were analyzed from virally suppressed WLH enrolled in the Women's Interagency HIV Study, who switched/added an INSTI to antiretroviral therapy: [raltegravir (RAL), dolutegravir (DTG), or elvitegravir (EVG)]. Percent body weight change was calculated from weights obtained a median 6 months pre-INSTI and 14 months post-INSTI initiation. Hair concentrations were measured with validated liquid chromatography-mass spectrometry (MS)/MS assays. Baseline (preswitch) weight status evaluated obese (body mass index, BMI, ≥30 kg/m
2 ) versus nonobese (BMI <30 kg/m2 ). Mixed models examined the drug hair concentration*baseline obesity status interaction for each INSTI. There were 169 WLH included: 53 (31%) switched to RAL, 72 (43%) to DTG, and 44 (26%) to EVG. Women were median age 47–52 years, predominantly Non-Hispanic Black, median CD4 counts >500 cells/mm3 , >75% with undetectable HIV-1 RNA. Over ∼1 year, women experienced median increases in body weight: 1.71% (−1.78, 5.00) with RAL; 2.40% (−2.82, 6.50) with EVG; and 2.48% (−3.60, 7.88) with DTG. Baseline obesity status modified the relationship between hair concentrations and percent weight change for DTG and RAL (p's < 0.05): higher DTG, yet lower RAL concentrations were associated with greater weight gain among nonobese women. Additional pharmacologic assessments are needed to understand the role of drug exposure in INSTI-associated weight gain. [ABSTRACT FROM AUTHOR]- Published
- 2023
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