Weight and body mass index (BMI) change was assessed among women after switch to integrase inhibitors (INSTIs) and/or tenofovir alafenamide (TAF). From 2006 to 2019, 1,458 women living with HIV enrolled in the Women's Interagency HIV Study and on antiretroviral therapy (ART) with ≥1 study visit before and after switching to INSTIs and/or TAF were included. Weight and BMI were compared pre- and postswitch to INSTI (by class and type) and/or TAF using multivariable linear mixed effects models; all models were also stratified by preswitch presence or absence of obesity (BMI ≥30 vs. <30 kg/m²). Mean age preswitch was 47 ± 6 years, 64% were black, mean CD4 = 475 ± 201 cells/mm³, 56% had HIV RNA <200 copies/mL, 36% switched to TAF but not INSTI, 60% to INSTI but not TAF, and 3.5% to TAF+INSTI. Time from pre- to postswitch was 12.8 ± 11.8 months. The INSTI-only group but not TAF groups had small but significant increases in weight and BMI: mean 79.2–80.6 kg and 30.2–30.7 kg/m², p's < .001, respectively, with congruent findings by INSTI type (p's ≤ .01). In stratified (preswitch BMI) analyses, only nonobese subgroups experienced increases in weight and BMI across all ART treatment groups (p's < .05). Significant, although small-to-medium, increases in weight and BMI occurred among nonobese women who switched to INSTIs and/or TAF over short follow-up. Given long-term health consequences of obesity particularly as a low-grade inflammatory condition, identifying women at highest risk of ART-associated weight gain is imperative.

中文翻译：

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HIV 感染女性改用整合酶抑制剂或替诺福韦艾拉酚胺后体重和体重指数发生变化

在改用整合酶抑制剂 (INSTIs) 和/或替诺福韦艾拉酚胺 (TAF) 后，对女性的体重和体重指数 (BMI) 变化进行了评估。从 2006 年到 2019 年，1,458 名感染艾滋病毒的妇女参加了妇女机构间艾滋病毒研究，并接受了抗逆转录病毒治疗 (ART)，并且在转换为 INSTIs 和/或 TAF 之前和之后进行了≥1 次研究访问。使用多变量线性混合效应模型将体重和 BMI 在转换前和转换后与 INSTI（按类别和类型）和/或 TAF 进行比较；所有模型还按开关前是否存在肥胖进行分层（BMI ≥30 与 <30 kg/m ²）。转换前的平均年龄为 47 ± 6 岁，64% 为黑人，平均 CD4 = 475 ± 201 个细胞/mm ³, 56% 的 HIV RNA <200 拷贝/mL，36% 转为 TAF 而不是 INSTI，60% 转为 INSTI 而不是 TAF，3.5% 转为 TAF+INSTI。从转换前到转换后的时间为 12.8 ± 11.8 个月。仅 INSTI 组而非 TAF 组在体重和 BMI 方面有小幅但显着的增加：平均 79.2–80.6 kg 和 30.2–30.7 kg/m ²，p's < .001，与 INSTI 类型一致的结果（p ≤ .01)。在分层（转换前 BMI）分析中，只有非肥胖亚组在所有 ART 治疗组中经历了体重和 BMI 的增加（p'小号 <.05）。在短期随访期间改用 INSTIs 和/或 TAF 的非肥胖女性中，体重和 BMI 显着增加，尽管是中小幅度增加。考虑到肥胖的长期健康后果，特别是作为一种低度炎症状态，确定 ART 相关体重增加风险最高的女性势在必行。