Weighing in on the Role of Integrase Strand Transfer Inhibitors (INSTIs) on Weight Gain: Fact or Fiction?

AbstractPurpose of ReviewThe goal of this manuscript was to review the growing body of evidence examining the relationship between integrase strand inhibitors (INSTIs) and weight gain in treatment-na ïve and treatment-experienced populations of people living with HIV. INSTIs have proven to be efficacious in virologic suppression in combination with other antiretrovirals (ARVs); however, recent data has demonstrated a potential link between weight gain and INSTIs, causing concern for risk of dev eloping further metabolic complications. The intent of this review was to understand the magnitude of the weight gain and whether INSTIs were the sole cause.Recent FindingsOf 71 studies conducted on this topic, 25 trials were evaluated and organized into treatment-na ïve and treatment-experienced studies. While these studies were not designed homogeneously, clear patterns emerged while assessing the data. Among treatment-naïve populations, dolutegravir (DTG) generally exhibited greater levels of weight gain when compared with elvitegravir (EVG) and raltegravir (RAL). Furthermore, some studies demonstrated greater weight gain with DTG-containing groups when combined with tenofovir alafenamide (TAF). Studies in treatment-experienced patients switching to an INSTI-based regimen exhibited similar patterns. DTG was once again associated with the most weight g ain in this population, with weight gain also exhibited with RAL and EVG. Due to bictegravir (BIC) being a newer agent, there was ...
Source: Current Infectious Disease Reports - Category: Infectious Diseases Source Type: research