Regional variation in weight change after the transition to dolutegravir in Uganda and South Africa.

Autor:	Migisha R; Mbarara University of Science and Technology, Mbarara, Uganda., Chen G; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA., Muyindike WR; Mbarara University of Science and Technology, Mbarara, Uganda., Aung TN; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA., Nanfuka V; Mbarara University of Science and Technology, Mbarara, Uganda., Komukama N; Mbarara University of Science and Technology, Mbarara, Uganda., Chandiwana N; Wits Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg., Shazi G; Africa Health Research Institute, Durban., Tien D; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA., Moosa MS; Department of Infectious Diseases, University of KwaZulu-Natal, Durban, South Africa., Gupta RK; Africa Health Research Institute, Durban.; University of Cambridge, Cambridge., Pillay D; University College London, London, United Kingdom., Marconi VC; Emory University School of Medicine and Rollins School of Public Health, Emory University, Atlanta, GA., Hedt-Gauthier B; Harvard Medical School., Venter WDF; Wits Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg., Siedner MJ; Mbarara University of Science and Technology, Mbarara, Uganda.; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA.; Africa Health Research Institute, Durban.; Harvard Medical School.; Division of Infectious Diseases, Massachusetts General Hospital., McCluskey SM; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School.; Division of Infectious Diseases, Massachusetts General Hospital., Manne-Goehler J; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA.; Division of Infectious Diseases, Massachusetts General Hospital.; Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	AIDS (London, England) [AIDS] 2024 Jul 15; Vol. 38 (9), pp. 1314-1322. Date of Electronic Publication: 2024 Mar 19.
DOI:	10.1097/QAD.0000000000003888
Abstrakt:	Background: People with HIV (PWH) on integrase inhibitor-based regimens may be at risk of excess weight gain, but it is unclear if this risk is consistent across settings. We assessed weight change over 48 weeks among PWH who were transitioned to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD). Design: We conducted a prospective cohort study at public-sector HIV clinics in Uganda and South Africa. Methods: Eligible participants were adults who were transitioned to TLD. Weight was measured at enrollment, 24-, and 48-weeks post TLD transition. Our outcomes were weight change, change in waist circumference, and clinically significant weight gain, defined as ≥10% increase in weight from baseline, over 48 weeks. We used linear mixed-effects regression models, adjusted for demographic factors, to estimate weight gain and identify risk factors. Results: Weight data were available for 428 participants in Uganda and 367 in South Africa. The mean weight change was 0.6 kg [95% CI: 0.1-1.0] in Uganda and 2.9 kg [2.3-3.4] in South Africa ( P  < 0.001). The mean change in waist circumference was 0.8 cm [95% CI: 0.0-1.5]) in Uganda and 2.3 cm [95% CI: 1.4-3.2] in South Africa ( P  = 0.012). Clinically significant weight gain occurred in 9.8% [7.0-12.6] of participants in Uganda and 18.0% [14.1-21.9] in South Africa ( P  < 0.001). After adjustment, PWH gained significantly less weight in Uganda than in South Africa. Conclusions: PWH in South Africa experienced significantly greater weight gain and increases in waist circumference compared to Uganda. Strategies to address weight gain in PWH should be carefully considered and may vary by region. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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