Alterações no índice de massa corporal: Coorte em indivíduos em uso de dolutegravir
DOI:
https://doi.org/10.33448/rsd-v10i16.23189Keywords:
Dolutegravir; Integrase inhibitor; Antiretroviral therapy; Body mass index; BMI.Abstract
Goal: To assess body mass index (BMI) changes in people living with HIV (PLHIV) and using antiretroviral therapy (ART) with dolutegravir (DTG) and its associated factors. Methods: Retrospective and prospective cohorts of PLHIV who started ART with DTG or used DTG after changing the therapeutic regimen, from Belo Horizonte, between February/2017 and March/2020. Data were gathered from clinical records of the Drug Logistics and Laboratory Test Control Systems. BMI changes were analyzed in the following week intervals 1-24(t24), 25-48(t48), 49-72(t73), and 73-96(t96) using the Wilcoxon test and generalized estimation equation (GEE) model, at 5% significance level. Results: A total of 614 individuals were included and average was 38.4 years old. Most were men (85.5%) and 52.3% had started ART with DTG. These individuals, and the immunosuppressed ones, showed significant increases in BMI when compared to those who used DTG after switching therapeutics or the non-immunosuppressed ones (p-value <0.05). After 96 weeks, individuals starting ART with DTG had a mean increase in BMI of 1.02 Kg/m2, whereas those who used DTG after the therapeutic change had an increase of 0.56 Kg/m2 (p<0.05). DTG use length, ART type, immune status, baseline BMI, and age were associated (p<0.05) with BMI increases. Conclusions: We observed an increase in BMI both in individuals starting ART with DTG use and those using it after changing the therapeutic regimen.
References
Adam, May, M. T., Vehreschild, J.-J., Obel, N., Gill, M. J., Crane, H. M., & Sterne, J. A. C. (2017). Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies. The Lancet. HIV, 4(8), e349–e356. https://doi.org/10.1016/S2352-3018(17)30066-8
Arner, P., Bernard, S., Appelsved, L., Fu, K. Y., Andersson, D. P., Salehpour, M., & Spalding, K. L. (2019). Adipose lipid turnover and long-term changes in body weight. Nature Medicine, 25(9), 1385–1389. https://doi.org/10.1038/s41591-019-0565-5
Bakal, D. R., Coelho, L. E., Luz, P. M., Clark, J. L., De Boni, R. B., Cardoso, S. W., & Grinsztejn, B. (2018). Obesity following ART initiation is common and influenced by both traditional and HIV-/ART-specific risk factors. Journal of Antimicrobial Chemotherapy, 73(8). https://doi.org/10.1093/jac/dky145
Bourgi, K., Jenkins, C. A., Rebeiro, P. F., Palella, F., Moore, R. D., Altoff, K. N., & Koethe, J. R. (2020). Weight gain among treatment-naïve persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada. Journal of the International AIDS Society, 23(4), 1–8. https://doi.org/10.1002/jia2.25484
BRASIL. (2018). Protocolo clínico e diretrizes terapêuticas para o manejo da infecção pelo hiv em adultos. In Ministério da Saúde. Secretaria de Vigilância em Saúde (1st ed., p. 410). Retrieved from http://www.aids.gov.br/pt-br/pub/2013/protocolo-clinico-e-diretrizes-terapeuticas-para-manejo-da-infeccao-pelo-hiv-em-adultos
BRASIL. (2019). Boletim Epidemiológico HIV / Aids | 2019. Brasilia-DF: Ministério da Saúde. Secretaria de Vigilância em Saúde.
Castelo Filho, A., & Pott-Junior, H. (2016). Simplificação do tratamento antirretroviral combinado na prática clínica. The Brazilian Journal of Infectious Diseases, 2(4), 107–111. Retrieved from http://www.bjid.org.br/en-simplificacao-do-tratamento-antirretroviral-combinado-articulo-X2177511716574472
Castro, A. D. C. O., Silveira, E. A., Falco, M. D. O., Nery, M. W., & Turchi, M. D. (2016). Overweight and abdominal obesity in adults living with HIV/AIDS. Revista Da Associacao Medica Brasileira, 62(4), 353–360. https://doi.org/10.1590/1806-9282.62.04.353
Debroy, P., Sim, M., Erlandson, K. M., Falutz, J., Prado, C. M., Brown, T. T., & Lake, J. E. (2019). Progressive increases in fat mass occur in adults living with HIV on antiretroviral therapy, but patterns differ by sex and anatomic depot. Journal of Antimicrobial Chemotherapy, 74(4). https://doi.org/10.1093/jac/dky551
Eckard, A. R., & McComsey, G. A. (2020). Weight gain and integrase inhibitors. Current Opinion in Infectious Diseases, 33(1), 10–19. https://doi.org/10.1097/QCO.0000000000000616
Halekoh, U., Højsgaard, S., & Yan, J. (2006). The R package geepack for generalized estimating equations. Journal of Statistical Software, 15(2), 1–11. https://doi.org/10.18637/jss.v015.i02
Hill, A., Waters, L., & Pozniak, A. (2019). Are new antiretroviral treatments increasing the risks of clinical obesity? Journal of Virus Eradication, 5(1), 41–43. https://doi.org/PMID 30800425
Hubbard, A. E., Ahern, J., Fleischer, N. L., Laan, M. Van Der, Lippman, S. A., Jewell, N., & Satariano, W. A. (2010). To GEE or not to GEE: Comparing population average and mixed models for estimating the associations between neighborhood risk factors and health. Epidemiology, 21(4), 467–474. https://doi.org/10.1097/EDE.0b013e3181caeb90
Koethe, J. R., Jenkins, C. A., Lau, B., Shepherd, B. E., Justice, A. C., Tate, J. P., & Moore, R. D. (2016). Rising Obesity Prevalence and Weight Gain among Adults Starting Antiretroviral Therapy in the United States and Canada. AIDS Research and Human Retroviruses, 32(1). https://doi.org/10.1089/aid.2015.0147
Koethe, J. R., Lagathu, C., Lake, J. E., Domingo, P., Calmy, A., Falutz, J., & Capeau, J. (2020). HIV and antiretroviral therapy-related fat alterations. Nature Reviews Disease Primers, 6(1). https://doi.org/10.1038/s41572-020-0181-1
Lake, J. E. (2017). The Fat of the Matter: Obesity and Visceral Adiposity in Treated HIV Infection. Current HIV/AIDS Reports, 14(6). https://doi.org/10.1007/s11904-017-0368-6
Obry-Roguet, V., Brégigeon, S., Cano, C. E., Lions, C., Zaegel-Faucher, O., Laroche, H., & Poizot-Martin, I. (2018). Risk factors associated with overweight and obesity in HIV-infected people: Aging, behavioral factors but not cART in a cross-sectional study. Medicine (United States), 97(23). https://doi.org/10.1097/MD.0000000000010956
Oliveira, J., Peruch, M. H., Gonçalves, S., & Haas, P. (2016). Padrão hormonal feminino : menopausa e terapia de reposição Female hormone pattern : menopause and replacement therapy. Revista Brasileira de Análises Clínicas, 48(3), 198–210. Retrieved from http://www.rbac.org.br/wp-content/uploads/2016/11/RBAC-48-3-2016-completa-corrigida-22.11.16-final.pdf
Santos Pinto Guimarães, L., Naomi Hirakata, V., & Alegre, P. (2012). Use of the Generalized estimatinG eqUation model in lonGitUdinal data analysis. Revista HCPA, 32(4), 503–511. Retrieved from http://seer.ufrgs.br/hcpa503
Sax, P. E., Erlandson, K. M., Lake, J. E., McComsey, G. A., Orkin, C., Esser, S., & Koethe, J. R. (2019). Weight Gain Following Initiation of Antiretroviral Therapy: Risk Factors in Randomized Comparative Clinical Trials. Clinical Infectious Diseases, (Xx Xxxx), 1–11. https://doi.org/10.1093/cid/ciz999
Trabert, B., Graubard, B. I., Nyante, S. J., Rifai, N., Bradwin, G., Elizabeth, A., & Mcglynn, K. A. (2013). Relationship of sex steroid hormones with body size and with body composition measured by dual-energy X-ray absorptiometry in US men. Cancer Causes Control, 23(12), 1881–1891. https://doi.org/10.1007/s10552-012-0024-9.Relationship
Venter, W. D. F., Moorhouse, M., Sokhela, S., Fairlie, L., Mashabane, N., Masenya, M., & Hill, A. (2019). Dolutegravir plus two different prodrugs of tenofovir to treat HIV. New England Journal of Medicine, 381(9), 803–815. https://doi.org/10.1056/NEJMoa1902824
WHO. (2004). BMI Classification. https://web.archive.org/web/20090418181049/http://www.who.int/bmi/index.jsp?introPage=intro_3.html
Yuh, B., Tate, J., Butt, A. A., Crothers, K., Freiberg, M., Leaf, D., & Justice, A. C. (2015). Weight change after antiretroviral therapy and mortality. Clinical Infectious Diseases, 60(12), 1852–1859. https://doi.org/10.1093/cid/civ192
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Cléssius Ribeiro de Souza; Maria das Graças Braga Ceccato; Simone Furtado dos Santos; Marcos Paulo Gomes Mol; Micheline Rosa Silveira
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
