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Journal Articles Journal of Antimicrobial Chemotherapy Year : 2023

Striking differences in weight gain after cART initiation depending on early or advanced presentation: Results from the ANRS CO4 FHDH cohort

1 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
2 CHU Saint-Antoine [AP-HP]
3 CHU Dijon
4 CIC-EC - Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques
5 Service de pneumologie [Béclère]
6 CESP - Centre de recherche en épidémiologie et santé des populations
7 UT - Université de Tours
8 CHU Nantes - Centre Hospitalier Universitaire de Nantes
9 Centre Hospitalier Victor Dupouy
10 Hôpital Raymond Poincaré (Garches) [GHU AP-HP Université Paris-Saclay]
11 Université Paris-Saclay
12 Hôpital Necker - Enfants Malades [AP-HP]
13 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
14 IC UM3 (UMR 8104 / U1016) - Institut Cochin
15 CMIP - Centre Médical de l'Institut Pasteur
16 APHM - Assistance Publique - Hôpitaux de Marseille
17 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
18 CHU Pitié-Salpêtrière [AP-HP]
19 Hôpital Delafontaine
20 Hôpital Cochin [AP-HP]
21 CIC 1417 - CIC Cochin Pasteur
22 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
23 Hôpital Henri Mondor
24 Hôpital de Riaumont [Lievin]
25 Hôpital Hôtel-Dieu [Paris]
26 Hôpitaux Sud - Hôpital Sainte-Marguerite [CHU - APHM]
27 AMU - Aix Marseille Université
28 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
29 BRM - ARN régulateurs bactériens et médecine
30 CRSA - Centre de Recherche Saint-Antoine
31 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases

Abstract

BACKGROUND: Many studies have reported weight gain in ART-naive people living with HIV (PWH) initiating an integrase strand-transfer inhibitor-based regimen. We studied the impact of early or advanced presentation and that of individual drugs in PWH initiating combined ART (cART) between 2012 and 2018. METHODS: From the French Hospital Database HIV cohort, we assessed factors associated with a weight gain >/=10%, weight change after cART initiation or BMI increase >/=5 kg/m2 up to 30 months. The analyses were conducted overall, and among PWH with early (primary infection or CD4 >350/mm3 and viral load <100 000 copies/mL, without AIDS) and advanced presentation (AIDS or CD4 <200/mm3, not during primary infection). RESULTS: At 30 months, 34.5% (95% CI: 33.5-35.6) of the 12 773 PWH had a weight gain >/=10%, with 20.9% (95% CI: 19.6-22.2) among the 5794 with early presentation and 63.1% (95% CI: 60.9-65.3) among the 3106 with advanced presentation. Weight gain was 2.8 kg (95% CI: 2.0-3.7) for those with early presentation and 9.7 kg (95% CI: 8.4-11.1) for those with advanced presentation. Most weight gain occurred in the first 12 months. Underweight and obese PWH were at significantly higher risk of a BMI increase >/=5 kg/m2 than normal-weight PWH. Results differed within classes and by outcome. Raltegravir and dolutegravir were consistently associated with greater weight gain than the other third agents. Tenofovir alafenamide was also associated with higher weight gain than tenofovir disoproxil or abacavir. CONCLUSIONS: After initiating cART, PWH with early presentation exhibited a small weight gain, whereas it was large among those with advanced presentation. The choice of ART should account for the risk of weight gain, especially for PWH who present with advanced disease and/or are obese.
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Dates and versions

hal-03968711 , version 1 (07-03-2023)

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Sophie Grabar, Valérie Potard, Lionel Piroth, Sophie Abgrall, Louis Bernard, et al.. Striking differences in weight gain after cART initiation depending on early or advanced presentation: Results from the ANRS CO4 FHDH cohort. Journal of Antimicrobial Chemotherapy, 2023, 78 (3), pp.757-768. ⟨10.1093/jac/dkad007⟩. ⟨hal-03968711⟩
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