Changes in Waist Circumference in HIV-Infected Individuals Initiating a Raltegravir or Protease Inhibitor Regimen: Effects of Sex and Race.

Autor: Bhagwat P; University of California, Los Angeles, Los Angeles, California., Ofotokun I; Emory University School of Medicine, Department of Medicine, Atlanta, Georgia., McComsey GA; Case Western University, Cleveland, Ohio., Brown TT; Johns Hopkins University School of Medicine, Baltimore, Maryland., Moser C; Harvard T. H. Chan School of Public Health, Boston, Massachusetts., Sugar CA; University of California, Los Angeles, Los Angeles, California., Currier JS; University of California, Los Angeles, Los Angeles, California.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2018 Nov 16; Vol. 5 (11), pp. ofy201. Date of Electronic Publication: 2018 Nov 16 (Print Publication: 2018).
DOI: 10.1093/ofid/ofy201
Abstrakt: Background: This study investigates the association of clinical and demographic predictors with abdominal fat gain, measured using waist circumference (WC) and self-reported abdominal size.
Methods: We analyzed data from ACTG A5257, a clinical trial that randomized treatment-naïve HIV-infected participants to 1 of 3 antiretroviral regimens: raltegravir (RAL) or the protease inhibitors (PIs) atazanavir/ritonavir (ATV/r) or darunavir/ritonavir (DRV/r), each in combination with tenofovir disoproxil fumarate/emtricitabine. Associations of treatment and baseline/demographic characteristics with 96-week WC change were assessed using repeated-measures models. Ordinal logistic regression was used to examine the associations of predictors with week 96 self-reported abdominal changes.
Results: The study population (n = 1809) was 76.0% male and predominantly black non-Hispanic (41.9%) and white non-Hispanic (34.1%). Mean baseline WC was 90.6 cm, with an average 96-week increase of 3.4 cm. WC increases were higher in the RAL arm compared with DRV/r ( P = .0130). Females experienced greater increases in WC on RAL vs ATV/r than males ( P = .0065). Similarly, a larger difference in WC change was found for RAL vs DRV/r for black vs nonblack individuals ( P = .0043). A separate multivariable model found that in addition to the treatment regimen, higher baseline viral load and lower CD4+ were also associated with WC increases.
Conclusions: With antiretroviral therapy initiation, higher WC increases in the RAL arm compared with PIs were more pronounced in female and black participants, and a more advanced baseline HIV disease state was a strong predictor of larger abdominal increases. Understanding factors predisposing individuals to abdominal fat gain could inform health management after therapy initiation.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje