No overall impact on body mass index for age change after dolutegravir initiation in a French paediatric cohort.

Autor: Frange P; Laboratoire de Microbiologie Clinique, Hôpital Necker - Enfants Malades, Groupe Hospitalier Assistance Publique - Hôpitaux de Paris, Centre Université de Paris (APHP.CUP), Paris, France.; EHU 7328 PACT, Institut Imagine, Université de Paris, Paris, France.; Unité d'Immunologie, Hématologie et Rhumatologie Pédiatriques, AP-HP, Hôpital Universitaire Necker - Enfants Malades, Paris, France., Avettand-Fenoel V; Laboratoire de Microbiologie Clinique, Hôpital Necker - Enfants Malades, Groupe Hospitalier Assistance Publique - Hôpitaux de Paris, Centre Université de Paris (APHP.CUP), Paris, France.; Université de Paris, Paris, France.; INSERM, U1016, CNRS, UMR8104, Institut Cochin, Paris, France., Veber F; Unité d'Immunologie, Hématologie et Rhumatologie Pédiatriques, AP-HP, Hôpital Universitaire Necker - Enfants Malades, Paris, France., Blanche S; Unité d'Immunologie, Hématologie et Rhumatologie Pédiatriques, AP-HP, Hôpital Universitaire Necker - Enfants Malades, Paris, France.; Université de Paris, Paris, France.
Jazyk: angličtina
Zdroj: HIV medicine [HIV Med] 2022 Oct; Vol. 23 (9), pp. 1019-1024. Date of Electronic Publication: 2022 Mar 20.
DOI: 10.1111/hiv.13302
Abstrakt: Objectives: Increased weight gain with dolutegravir use is increasingly scrutinized in adults, but published data in paediatrics are limited and conflicting. This study aimed to provide long-term data about changes in body mass index (BMI) in French children (aged 3-9 years) and adolescents (aged 10-17 years) receiving dolutegravir.
Patients and Methods: This retrospective monocentric study included 97 subjects who received a dolutegravir-based regimen for ≥12 months in 2014-2021. We evaluated the mean change in age- and sex-matched standardized BMI z score (BMIz) per year of dolutegravir exposure and compared the dynamics of BMIz change during the 12 months pre- vs. post-dolutegravir use when these data were available.
Results: At the time of dolutegravir initiation, most of the subjects were antiretroviral therapy (ART) experienced (89.7%), displayed virological suppression (73.2%), and had normal weight for their age (78.4%). Median follow-up was 30 months (interquartile range [IQR] 19-45). The mean rate of change in BMIz was +0.03 z score/year of dolutegravir exposure (95% confidence interval [CI] -0.08-0.13) in the entire cohort. It was lower in children than in adolescents (-0.08 [95% CI -0.23-0.08] vs. +0.16 [95% CI 0.06-0.26], respectively; p = 0.04) and in individuals with baseline BMI ≥50 th percentile than in those with lower BMI (-0.06 [95% CI -0.14-0.01] vs. +0.08 [95% CI -0.07-0.23], respectively; p = 0.001). Trajectories of BMIz change 12 months pre- vs. post-dolutegravir were similar, except in subjects with baseline BMI ≥50 th percentile, whose rate of BMIz change was lower post-dolutegravir (difference: -0.23 [95% CI -0.46-0.00]; p = 0.04).
Conclusion: We found no evidence of change in BMIz in French children initiating dolutegravir. These reassuring findings maintain the primary position of dolutegravir among paediatric therapeutic options.
(© 2022 British HIV Association.)
Databáze: MEDLINE
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