Infectious Disease · 2 h ago
ART switches linked to weight-trajectory changes in older adults with HIV in China
A nationwide retrospective cohort study of 5,618 people with HIV aged 50 years or older in China examined weight trajectories around antiretroviral therapy (ART) regimen switches. Switching to an integrase strand transfer inhibitor (INSTI) regimen was associated with steeper weight gain, while switching from an INSTI to a non-nucleoside reverse transcriptase inhibitor was associated with a slower rate of gain.
- Cohort included 5,618 adults with HIV aged 50 years or older.
- Weight gain accelerated after switches to INSTI-based regimens.
- INSTI-to-NNRTI switches were associated with a slower gain trajectory.
- Findings are observational and do not establish causation.
Researchers conducted a retrospective cohort study of 5,618 people with HIV aged 50 years or older across 19 cities in China, using data from the National Free Antiretroviral Therapy Programme. Piecewise mixed-effects models assessed weight-change trajectories around switches among non-nucleoside reverse transcriptase inhibitor (NNRTI), integrase strand transfer inhibitor (INSTI), and protease inhibitor (PI) regimens.
The adjusted weight-change slope rose from 0.41 kg/year before a regimen switch to 0.90 kg/year afterward (p=0.03). Slope changes were +0.76 kg/year after NNRTI-to-INSTI switches (p=0.03), +4.76 kg/year after PI-to-INSTI switches (p<0.01), and −2.07 kg/year after INSTI-to-NNRTI switches (p=0.03). Exploratory analyses suggested larger associations among women, adults aged 65 years or older, and participants with baseline metabolic risk. The retrospective findings show associations, not causation; the authors support weight and cardiometabolic monitoring after regimen changes and say ART decisions should remain individualized.
In practice
In older adults with HIV, this Chinese cohort found steeper weight-gain trajectories after switches to INSTI-based ART and a slower trajectory after switching from an INSTI to an NNRTI. The authors support monitoring weight and cardiometabolic risk after regimen changes. These retrospective associations do not establish that the switches caused the changes, and the results do not show that changing ART to manage weight improves clinical outcomes. The authors state that ART decisions should remain individualized.
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Journal of the American Geriatrics Society: Weight Trajectories Across Antiretroviral Therapy Regimen Switches in Older People With HIV in China: A Nationwide Multicenter Cohort Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.