With obesity on the rise among people living with HIV (PLWH), there is growing concern that weight gain may result as an undesired effect of antiretroviral therapy (ART). This analysis sought to assess the association between ART regimens and changes in body mass index (BMI) among ART-experienced, virologically suppressed PLWH. ART-experienced, virologically suppressed PLWH ≥18 years of age in the Observational Pharmacoepidemiology Research and Analysis (OPERA) cohort were included for analysis if prescribed a new regimen containing one of the following core agents: dolutegravir (DTG), elvitegravir/cobicistat (EVG/c), raltegravir (RAL), rilpivirine (RPV), or boosted darunavir (bDRV), for the first time between August 1, 2013 and December 31, 2017. Multivariable linear regression was used to assess the association between regimen and mean changes in BMI at 6, 12, and 24 months after switch. In unadjusted analyses, BMI increases ranged from 0.30 kg/m² (bDRV) to 0.83 kg/m² (RPV) at 24 months following switch, but gains were observed with every regimen. In adjusted analyses, compared to DTG, only bDRV was associated with a smaller increase in BMI at all time points, while EVG/c and RAL were associated with smaller increases in BMI at 6 months only. Overall, results were consistent in analyses stratified by baseline BMI category. BMI increases were relatively small but followed an upward trend over time in this cohort of treatment-experienced, suppressed PLWH. Gains were attenuated with a longer period of follow-up. BMI gains did not differ by regimens, except for bDRV regimens, which were consistently associated with smaller BMI increases than DTG.

中文翻译：

---

在美国接受过治疗、病毒学抑制的 HIV 感染者与抗逆转录病毒治疗方案转换相关的体重指数变化

随着 HIV 感染者 (PLWH) 肥胖症的增加，人们越来越担心抗逆转录病毒疗法 (ART) 可能会导致体重增加。该分析旨在评估 ART 方案与经历过 ART 的病毒学抑制的 PLWH 的体重指数 (BMI) 变化之间的关联。观察性药物流行病学研究和分析 (OPERA) 队列中 18 岁以上、经历过 ART 病毒学抑制的 PLWH 被纳入分析，如果处方包含以下核心药物之一的新方案：dolutegravir (DTG)、elvitegravir/cobicistat (EVG) /c)、raltegravir (RAL)、rilpivirine (RPV) 或加强型地瑞纳韦 (bDRV)，在 2013 年 8 月 1 日至 2017 年 12 月 31 日期间首次出现。使用多变量线性回归来评估方案与转换后 6、12 和 24 个月时 BMI 平均变化之间的关联。在未经调整的分析中，BMI 增加范围为 0.30 kg/m² (bDRV) 到 0.83 kg/m ² (RPV) 在转换后 24 个月，但每个方案都观察到增加。在调整后的分析中，与 DTG 相比，只有 bDRV 与所有时间点的 BMI 增加较小相关，而 EVG/c 和 RAL 仅与 6 个月时 BMI 的较小增加相关。总体而言，结果在按基线 BMI 类别分层的分析中是一致的。在这组经历过治疗的 PLWH 受抑制的队列中，BMI 的增加相对较小，但随着时间的推移呈上升趋势。随着随访时间的延长，收益减弱。除了 bDRV 方案外，BMI 增加没有因方案而异，bDRV 方案始终与比 DTG 更小的 BMI 增加相关。