Tivicay weight gain 2 kg in the TDF-based Observational data from Nigeria, presented at HIV Glasgow 2020, showed weight gain in people with HIV switching to dolutegravir (DTG)-based ART. → It is important therefore that children ke ep planned doctor’s appointments. Weight increase (both lean and fat mass) was greatest in the TAF-based group and among female patients (mean increase, 6. We compared weight changes among adults (≥18 years) initiating tenofovir disoproxil fumarate, lamivudine, and Although weight gain is an adverse effect of several HIV medications, switching medications does not seem to reduce weight gain. Dolutegravir monotherapy and body weight gain in antiretroviral naive patients. [PMC free There is limited data on dolutegravir (DTG)-associated weight gain from settings with a dual burden of HIV and overnutrition. org June 22, 2023 2351 Second-Line Dolutegravir for HIV Infection vir-boosted PI for at least 24 weeks, and had had a viral load of less than 50 copies per milliliter However, randomized trials have found that dolutegravir is associated with greater weight gain than efavirenz [4][5] [6] and observational studies have demonstrated varying magnitudes of weight Dolutegravir (DTG, Tivicay, Tivicay PD) Updated: June 27, 2024 . INSTI regimens, including those with DTG, are associated with weight gain and other drive this weight gain is unknown. Weight gain tended to be greater among women than men. ) Dolutegravir and TAF, which cripple different enzymes that HIV uses to copy itself, are considered state-of-the-art ARVs and are first-line treatments in the United States. Side effects observed in greater than 2% of study participants were diarrhea and headache. 73 kg/year, going up to 2. [3] Side effects may include trouble sleeping, weight gain, and rash. 1 The South African ADVANCE study reported more weight gain in participants randomised to dolutegravir than efavirenz, which was more marked among women. Researchers found that a weight gain of 10% or more of body weight after switching treatment was distributed as follows: Ngono Ayissi K, Gorwood J, Le Pelletier L, et However, both trials also described significant weight gain in patients in the dolutegravir-based treatment group. However, the study also found a higher incidence of weight gain – as measured by changes in body mass index (BMI), absolute weight and emergence of obesity – in people who received dolutegravir, especially in those Rizzardo S, Lanzafame M, Lattuada E, Luise D, Vincenzi M, Tacconelli E et al. If you've ever had hepatitis B, using dolutegravir can cause this virus to become active or get worse. We compared weight and blood pressure trends and examined the association between high blood pressure and weight gain among people living with HIV (PLHIV) switching to or starting DTG-based, efavirenz (EFV)-based and ritonavir-boosted atazanavir (ATV/r)-based ART in Zimbabwe. In some people the increased weight gain was modest – a few Managing weight gain with the use of newer generation HIV ART regimens is controversial. The weight gain in our trial among black male patients receiving the TAF-based regimen was similar to that seen in predominantly white men in registration studies comparing DTG with bictegravir weight gain; yellow eyes and skin; Incidence not known. 6 kg, respectively, while those who started on raltegravir-, lopinavir- and atazanavir-based treatment gained an average of 1. Most of that gain happens in the Learn about the side effects of Tivicay (dolutegravir), from common to rare, for consumers and healthcare professionals. pediatric patients weighing 3 to 14 kg (4 weeks and older, treatment-naïve, or treatment-experienced Weight gain on dolutegravir was faster in the first year but continued in the second year, whereas for other regimens weight gain plateaued after the first year. Similar results were seen in a US observational study of 495 individuals, This study aims to evaluate the association between dolutegravir (DTG) pharmacokinetic parameters and weight changes in treatment-experienced people with HIV (PWHIV) from the Assessment of weight gain in adult patients living with HIV receiving first-line dolutegravir-based or efavirenz-based ART regimens in routine care clinics in Tshwane district, South Africa: An The existing literature suggests that older ARVs, such as tenofovir disoproxil fumarate and efavirenz, suppress weight gain, but also that integrase inhibitors may stimulate Dolutegravir (DTG)-based antiretroviral therapy (ART) is currently the preferred first-line treatment for persons living with HIV (PLHIV) including children and adolescents in On average, the entire study cohort gained weight after ART initiation (). }, author={Sebastiano Rizzardo and Massimiliano Lanzafame and Emanuela Lattuada and Dora Combined antiretroviral therapy (cART) dramatically improved survival in people living with HIV (PLWH) but is associated with weight gain (WG), raising concern for a possible obesity epidemic in PLWH. Case studies: (1) • 1) A healthy person starts the new An observational study with 329 patients concluded that weight gain is a common finding in all patients starting ART and reinforce the initial stage of disease and use of TAF as factors Weight gain on dolutegravir: Association is not the same as causation South Afr J HIV Med. Weight gain is most marked if ART is started with CD4 counts below 200 cells/μL. Dolutegravir and rilpivirine can each cause a small, Weight gain has been reported in adults who were receiving Biktarvy, 6,7 with an associated increased risk of cardiometabolic complications, 8 but preliminary pediatric data regarding HTB. Women and non-whites appear to be the The belief that dolutegravir causes weight gain is widespread among people with HIV and clinicians, which can result in inappropriate antiretroviral switching, reduced Dolutegravir (DTG) has become a preferred component of first‐line antiretroviral therapy (ART) in many settings but may be associated with excess weight gain. 3 This observation has caused concern because women in If dolutegravir-associated weight gain is undesired and discourages ART adherence, this could lead to downstream effects on viral suppression, particularly in resource-constrained settings where patients do not have easy access to alternative regimens. 2 ± 6. 2021;10(3):373-375. 1097/QAD. 1500. While we did not find any association between gender or baseline CD4 count and weight gain, studies have shown that weight gain was significant in women [39, 40], and associated baseline CD4 counts . Reviewed: June 27, 2024 . This appeared to plateau by 24 months follow up. 13 The ADVANCE trial also suggested greater weight gain among patients using a tenofovir alafena-mide (TAF) based backbone relative to one that is teno-fovir disoproxil fumarate (TDF)-based. The 5 additional studies (1 prospective and 4 retrospective, including 1 in women only) examined weight changes in virologically suppressed, treatment-experienced persons who switched to or added an INSTI; 4 of 5 found Hsu R, Brunet L, Mounzer K, et al. INSTI regimens, including those with DTG, are associated with weight gain and other metabolic . 2023 May 15;24(1):1500. Hsu R, Brunet L, Mounzer K, et al. reported greater weight gain among CYP2B6 slow WHAT IS WEIGHT GAIN? The prevalence of obesity and overweight among people with HIV is rising globally. The impact of weight gain during HIV treatment on risk of pre-diabetes, diabetes mellitus Excessive weight gain associated with dolutegravir-based regimens is an emerging issue; however, the long-term metabolic consequences of this effect have not been fully understood. 3 ± 8. Aim: To evaluate the change in behavioral factors between PWH with and without clinically significant weight gain over 48 weeks post transition to DTG Children should keep scheduled doctor's visits because their TIVICAY dosage should be adjusted as they get older or gain weight. g. 7 mcmol/L) was reported after 48 weeks of therapy with dolutegravir plus lamivudine; a mean change from baseline of 0. Tivicay Summary Tivicay is the name given to a pill containing the anti-HIV drug dolutegravir. Since the introduction of integrase inhibitor-based antiretroviral treatment, clinical trials and cohorts around the world have reported weight gain in people with INSTI regimens, including those with DTG, are associated with weight gain and other metabolic effects, such as hyperglycemia and changes in folate metabolism, in both nonpregnant and pregnant adults with HIV. Some side effects of dolutegravir may occur that usually do not need medical attention. InSTIs commenced were primarily dolutegravir (DTG) in 84/136 patients (61. eCollection 2023. Dolutegravir transition and weight gain: an update Aug 2020 Professor Francois Venter Ezintsha, University of the Witwatersrand. 4 kg) than in those initiating dolutegravir–TDF–FTC (mean increase of 3. In a real-world population, patients gained more weight and were at higher risk of hypertension after switching from efavirenz to dolutegravir than those remaining on efavirenz. Viral load is the amount of virus in a patient’s blood. Integrase inhibitors have been associated with significant weight gain in people living with HIV, although the exact mechanism is Clayden P. doi: 10. The median time from dolutegravir initiation to hyperglycaemia onset was 4 months (IQR 2·5–4·5). → It is important therefore that children keep planned doctor’s appointments. trials of new HIV drugs introduced since 2003 show that people taking dolutegravir are at higher risk of substantial weight gain than people taking other antiretroviral drugs. Switching to Delstrigo (an NNRTI + old At 6 and 12 months, weight gain was highest among PWH on TDF/FTC+DTG and TAF/FTC+DTG. emphasize that weight gain is ubiquitous in ART The two-drug regimen dolutegravir plus lamivudine demonstrated durable efficacy for up to 3 years in phase III studies and a high barrier to resistance in treatment-naive and virologically suppressed people with HIV (PWH). 5 to 3. Therefore, before switching to tenofovir alafenamide The Bottom Line: We Wait, as the Debate on Weight Gain Continues. Norwood J, Turner M, Bofill C, Rebeiro P, Shepherd B, Bebawy S et al. tions showed evidence of weight gain among DTG users. Dolutegravir (Tivicay, Tivicay PD, DTG) Updated: January 31, 2024 . 18,19 The impact of these metabolic effects on pregnancy outcomes is unknown. Data associate INSTIs with weight gain. Dolutegravir was also shown to suppress patients’ viral load more quickly than previous treatments. Venter noted Dolutegravir transition and weight gain: an update Aug 2020 Professor Francois Venter Ezintsha, University of the Witwatersrand. [1] As of 2019, it is listed by the World Health Organization (WHO) as the first line treatment for adults, with tenofovir/lamivudine/efavirenz as an alternative. 23 August 2019. 5 kg (interquartile range, −1. 84; 95% CI, 1. 1% at week 24 in the iPrEx study, and showed less Weight gain and body mass index (BMI) increase are central issues in patients living with HIV who need to minimize the risk of metabolic disease. 19 In high-resource countries where undernutrition is less Data associate INSTIs and TAF with weight gain. Weight gain with dolutegravir and TAF in ADVANCE study continues out to week 192. It is estimated that up to 40% of people with HIV who where assigned female at Descovy is used in combination with other integrase inhibitors (e. Tablets should be dispersed in 15 mL of water if using three tablets or 20 mL of water if using four to six tablets, Excessive weight gain associated with dolutegravir initiation in a 10-year-old female with perinatally acquired human immunodeficiency virus: a case report and review of the literature. weight gain; yellow eyes and skin; Incidence not Brief report: weight gain in persons with HIV switched from efavirenz-based to integrase strand transfer inhibitor-based regimens. Goldberg, Bictegravir and dolutegravir were also associated with significant increases in BMI, þ1. and weight gain in PWH. Methods In Eswatini (at Matsanjeni), among 156 Dolutegravir (DTG)-based regimens have been recommended by the WHO as the preferred first-line and second-line HIV treatment in all populations. Findings BACKGROUND An unexpected excess in weight gain has recently been reported in course of dolutegravir (DTG) treatment. There is growing evidence that people who take the integrase inhibitor dolutegravir (DTG) are more likely to gain weight after starting treatment. Growing There was no statistically significant difference in weight gain depending on which integrase inhibitor a participant received, “though the dolutegravir slope was steepest,” Palella said. nlm. Dolutegravir (DTG)-based antiretroviral therapy (ART) is currently the preferred first-line treatment for persons living with HIV (PLHIV) including children and adolescents in many low- and middle-income countries including Uganda. 9 kg, 2. Weight gain was significant but particularly severe in Several large clinical trials have reported on weight gain after starting treatment: The ADVANCE study compared three different drug combinations. HIV and its treatment increase cardiac risk, and at least annual Oral route (tablet; tablet for suspension) Hypersensitivity Reactions. Evidence suggests an association with weight gain, particularly among black women. 4kg/m2 and þ2. 7 kg (95% CI: 2. 5% There is growing evidence that people who take the integrase inhibitor dolutegravir (DTG) are more likely to gain weight after starting treatment. 4102/sajhivmed. Forty-eight week efficacy results showed that both dolutegravir-based regimens were non-inferior to the efavirenz-based regimen. Modest weight gain is expected in people during adulthood. https://i-base. Weight increased is reported as a side effect among people who take Tivicay (dolutegravir sodium), especially for people who are male, 50-59 old, have been taking the drug for 1 - 6 Pediatric Patients: Treatment-naïve or treatment-experienced INSTI-naïve patients aged at least 4 weeks and weighing at least 3 kg. effects, such as hyperglycemia and changes in folate metabolism, in both nonpregnant and pregnant . info/htb/36581 In pregnancy, women receiving dolutegravir-based ART had greater intrapartum weight gain than did those taking efavirenz-based ART; however, it was still below the recommended weekly weight gain for a healthy pregnancy. 3 kg and the incidence of obesity on DTG/TDF/3TC was 27%, raising concerns about cardiovascular diseases and potential adherence issues. Dolutegravir doses are based on weight in children. remaining INSTI-naive (INSTI-n) on stable ART. At The researchers who designed the two retrospective studies that captured a signal of weight gain with dolutegravir were attempting to explore an idea to see if there was a The study was designed prior to the recognition of weight gain as a side effect associated with TAF or dolutegravir use. 4kg Weight gain of greater than 10% of body mass was significantly more likely to occur in women taking dolutegravir (44 vs 34%, p < 0. 15 to 2. Newer interventions are more effective at maintaining weight loss for people with established obesity than lifestyle measures but access Studies have shown that weight gain with Dovato can range from 2. The implication of switching to BFTAF causing greater weight gain than switching to DTG/3TC is that TAF caused weight to go up--assuming you believe that 3TC is interchangeable with FTC and BIC is interchangeable with DTG. 5kg and 6. We evaluated changes in Studies have shown that weight gain with Dovato can range from 2. Tivicay and Isentress belong to the same group of drugs, so they have some similar side effects. 2019 Aug 1;33(10):1673-1674. . Evidence suggests an Dolutegravir and weight gain: an unexpected bothering side effect? Menard A 1 , Meddeb L, Tissot-Dupont H, Ravaux I, Dhiver C, Mokhtari S, Tomei C, Brouqui P, Colson P, Weight gain in people living with HIV has been associated with exposure to integrase strand transfer inhibitors, particularly dolutegravir, in observational studies 1–7 and It's not clear whether this weight gain comes from an improvement in health with HIV treatment or from HIV treatment side effects. Dr. 96), being ART There has been a signal from two studies that suggest the possibility of weight gain among people who have used the integrase inhibitor dolutegravir (Tivicay and in Triumeq). Recent reports have View Tivicay and Tivicay PD medical content including medical information responses, product prescribing information, scientific posters, infographics and videos Antiretroviral Therapy It has been reported that ART-naïve or treatment-experienced PLWH who switched to DTG-based regimens experienced a higher weight gain than PLWH treated with other ART In addition, women progressing to overweight/obesity showed a mean weight gain of 17. People gained between 0. Case studies: (1) • 1) A healthy person starts the new dolutegravir- containing regimen. The median weight gain was 3·6 kg (IQR 0·0–8·5) in the bictegravir, emtricitabine, and tenofovir alafenamide group and 2·4 kg (−0·4 to 5·8) for those in the dolutegravir, abacavir, and lamivudine group. Find out more in our About HIV pages. 1 The South African ADVANCE study reported more Tivicay is the name given to a pill containing the anti-HIV drug dolutegravir. We evaluated changes in the rate of weight gain among treatment In the ADVANCE study the findings on an excessive weight gain predominantly detected in women suggested a sex-related factor, but life-style characteristics were also discussed as a potential cause of weight gain. DTG, an We would like to show you a description here but the site won’t allow us. • Children and adolescents weighing at least 20 kg can take the adult dose of 30 mg, once a day or 15 mg twice a day. , Tivicay [dolutegravir] and Isentress [raltegravir]) and sometimes members of other drug classes The real clinical implications of weight gain on cardiovascular risk still need to be defined, whereas weight gain in people who are not overweight should be considered a RESPOND: dolutegravir and TAF each lead to weight gain. While using dolutegravir, you may need frequent blood tests. And so, we have some preliminary data that switching off of TAF Learn about the side effects of Tivicay PD (dolutegravir), from common to rare, for consumers and healthcare professionals. Each tablet contains 60 milligrams (mg) abacavir, 5 mg dolutegravir, and 30 mg lamivudine. Weight gain is an uncommon side effect of Triumeq that has been reported in post-marketing reports – these are At 2 years, DTG led to nonsignificantly more weight gain than RAL, and both led to significantly more weight gain than ELV. 138 mg/dL was reported after 96 weeks of therapy with dolutegravir plus lamivudine. BACKGROUND Recent studies have reported weight gain in virologically-suppressed persons Children 3 months of age and older weighing less than 25 kg—Dose is base on body weight and must be determined by your doctor. It is taken in combination with other antiretroviral drugs. These side effects may go away during treatment as your body adjusts to the medicine There is a growing body of evidence from both observational and randomised trials implicating integrase inhibitors, particularly dolutegravir and bictegravir, with the development of weight gain and obesity in people living with HIV. Loss-of-function polymorphisms in CYP2B6 result in higher efavirenz concentrations, which Dolutegravir has been associated with weight gain, so keep track of your weight and pay attention to diet and exercise if you are starting Triumeq. 8 pounds) in the Tivicay plus Truvada group and 1 kg (2. Our study investigated perceptions of weight gain from DTG-based regimen use on body image and adherence of antiretroviral People with marked weight gain on dolutegravir-based ART should be screened for the metabolic syndrome and treated accordingly. Weight gain is a common side effect of antiretroviral therapy (ART). This review summarizes key clinical considerations of INSTIs in terms of clinical pharmacology, drug-drug interactions, resistance, and provides perspective on clinical decision-making. 10 DTG is an antiretroviral drug that belongs to the class of integrase strand transfer inhibitors (INSTIs) and was approved in Canada in October 2013. See Tables 2, 3, and 4 for complete pediatric dosing View Tivicay and Tivicay PD medical content including medical information responses, product prescribing information, scientific posters, infographics and videos The integrase inhibitors dolutegravir and bictegravir are associated with the greatest weight gains. 011 and p Background: Dolutegravir (DTG) use has been associated with increased risk for weight gain. They gain 20kg, and are classified “obese”, but there are no other complications. v24i1. The sub‐study was constrained to three urban research centres in Uganda, hence this may limit the generalizability of the results. Recent evidence suggests that initial combination antiretroviral therapy (cART), including integrase strand transfer inhibitors (INSTIs), is associated with greater weight gain There is growing evidence that people who take the integrase inhibitor dolutegravir (DTG) are more likely to gain weight after starting treatment. 10 DTG is an antiretroviral drug Studies have found that some people with HIV who take integrase inhibitors may experience more weight gain than those taking older HIV meds. 2019;33(10):1673–4. Serious and sometimes fatal hypersensitivity reactions, with multiple organ involvement, have occurred with abacavir, a component of the abacavir, dolutegravir, and lamivudine combination. However, scaling up dolutegravir during pregnancy can come at a cost. nih. 3 mcmol/L to 55. 1 for men that also Initiation of antiretroviral therapy (ART) is frequently associated with a short period of weight gain, particularly among patients with a lower pre-treatment body mass index (BMI) or more The integrase inhibitors raltegravir (Isentress) and dolutegravir (sold alone as Tivicay and a component of the Triumeq, Dovato and Juluca coformulations), as well as TAF, Virologic suppression at 18 months was similar between different ART classes. (Integrase inhibitors are Although weight gain can occur after starting any class of antiretroviral drug, it has most frequently been reported among those taking potent integrase inhibitors, including Integrase inhibitors and TAF (the type of tenofovir in Descovy) have been associated with a significant amount of weight gain in a lot of people. Methods: This was a longitudinal prospective study of PWH from the GEPPO cohort. 18, 31, 32, 33 Sufficient weight gain during pregnancy reduces the risk of preterm birth, small-for-gestational-age neonates Excessive weight gain associated with integrase strand transfer inhibitor (InSTI) antiretrovirals is an emerging issue; however, the metabolic consequences of this effect have not been established. Dolutegravir (DTG) is widely used for antiretroviral therapy (ART). Leonard et al. (FTC was not considered a factor in weight gain because it was used in all three arms of the study. But, some studies suggest that people taking Weight gain was greater in the dolutegravir group (median weight gain, 5·0 kg in the dolutegravir group and 3·0 kg in the efavirenz 400 mg group, p<0·001, and incidence of Unexpectedly, four of the reasons for discontinuation of dolutegravir-based combined antiretroviral therapies (cARTs) discontinued due to adverse effects of these cARTs A mean change from baseline of 10. 8%), followed by raltegravir (RAL) 25. 0 to 4. 4 kg, respectively) was significantly higher than that with Background: Dolutegravir is associated with more weight gain than efavirenz. Your doctor will decide how Tivicay should be given. Tivicay is generally well-tolerated and highly effective. At all examined study time points, weight gain was highest among PLWH starting dolutegravir. Studies suggest that people with suppressed virus (who are undetectable) on dolutegravir (Tivicay) + TDF/FTC (Truvada), TDF/3TC or TAF/FTC rapid weight gain; seizures; severe sleepiness; stomach pain; sudden decrease in the amount of urine; swelling of the face, fingers, hands, lower legs, or ankles; Increased weight, increased blood lipid levels ; Increased fasting cholesterol (greater than 240 mg/dL: up to 22%), decreased phosphorus (2. Authors Purpose of Review The purpose of this review is to outline a practical clinical approach to monitoring and managing integrase strand transfer inhibitor (INSTI)-associated In the NAMSAL study, which randomized ART-naïve participants in Cameroon to dolutegravir or efavirenz, both with TDF and lamivudine, there was greater median weight gain The effects of sex on weight gain with dolutegravir (DTG) based antiretroviral therapy (ART) among treatment-naïve participants in a lower income, sub-Saharan population Dolutegravir (Tivicay, Tivicay PD, DTG) Updated: January 31, 2024 . Excessive weight gain associated with dolutegravir-based regimens is an emerging issue; however, the long-term metabolic consequences of this effect have not been fully understood. Serum creatinine, estimated creatinine clearance, urine glucose, and urine protein should be obtained before initiating Biktarvy and should be monitored. 0) in the ritonavir-boosted PI In addition, there might be other common factors that were associated with weight gain after taking DTG, such as race, gender, pre-treatment VL, and CD4+ T-cell count, etc. gov/32448908. We have previously demonstrated that ART-naïve patients starting DTG in Kenya gain significantly more weight compared to those starting a Non DOI: 10. In total, Palella and colleagues attributed 87% of weight gain in the first eight months after the switch and 27% of weight gain after those first eight Weight gain among treatment-naive individuals initiating dolutegravir-based therapy is greater than in treatment-experienced people switching to dolutegravir-based regimens. CYP2B6 metaboliser genotype was associated with weight gain in PLWH starting efavirenz-based ART. However, it has been unclear how integrase inhibitors might interfere with metabolism and cause fat gain. 3 to 13. 10 DTG is an antiretroviral drug Background: Dolutegravir is associated with more weight gain than efavirenz. The above studies suggest that weight gain with DTG may be worse than other INSTIs. clay-colored stools; decreased appetite; headache; stomach pain or tenderness; Other side effects of dolutegravir. 2 kg) and women had a There is ongoing debate about whether weight gain is associated with dolutegravir, as has been seen in some studies. 1 kg and 2. Baseline CD4 <200 cells/mm 3 (HR, 1. There is limited data on dolutegravir (DTG)-associated weight gain from settings with a dual burden of HIV and overnutrition. 2 pounds) in the Atripla group. Characterizations of weight gain following antiretroviral regimen initiation in treatment-naïve individuals living with HIV. J Acquir Immune Defic Syndr 2017; 76:527–31. Body weight gain in people living withHIV(PLWH)is a complex, multifactorial issue. While Tivicay and generic 3TC can be used together, there is no generic version of Dovato, so • Children’s dose of Tivicay needs to be adjusted as they get older or gain weight. Formulations . [Google Scholar] 58. Dolutegravir with emtricitabine and tenofovir alafenamide or tenofovir disoproxil weight gain around your neck, upper back, breast, or waist; Managing side effects (general information) For healthcare professionals. For example, The recommended weight-based dosage of TIVICAY PD tablets for oral suspension in . Growing evidence shows that this leads to a higher incidence of hyperglycemia, hypertension, and metabolic syndrome, along with elevated cardiovascular risk. • Children’s dose of Tivicay needs to be adjusted as they get older or gain weight. Because of the widespread use of dolutegravir and its role in epidemic control, identifying Results. 1 September 2022. This review was conducted In the case group, hyperglycaemia events were severe (in 15 of 16 patients), 2 and the majority were preceded by weight loss between dolutegravir initiation and presentation, rather than weight gain . Weight Gain with Dolutegravir. 18 kg/week), and weight loss between 18±2 and 36±2 weeks gestation, adjusting for demographic and clinical variables. A French research group presented evidence that the integrase inhibitors dolutegravir and raltegravir have direct Recent studies support the concept that weight gain and treatment emergent obesity are worse with INSTI-based regimens, particularly dolutegravir. General side effects are uncommon and can include The adjusted average weight gain associated with raltegravir-based regimens at 6 and 18 months (3. Risk of weight Conclusions. 05) when compared to efavirenz, but there The incidence of weight gain with Triumeq is not known, but recent studies have reported that one in six people starting HIV treatment gain at least 10% in body weight over Polymorphisms coding loss-of-function in the CYP2B6 gene result in higher efavirenz concentrations. Concomitant increases in waist circumference suggest that this weight gain The introduction of dolutegravir (DTG) in treating HIV has shown enhanced efficacy and tolerability. The usual adult dose of dolutegravir is one 50mg The postulated weight gain associated with DTG may have different effects on pregnancy outcomes depending on the individual’s weight entering pregnancy . • Children and adolescents weighing at least 20 kg can take the adult dose of 50 mg, once a day or 25 mg twice daily . Dolutegravir-based first-line non-inferior to efavirenz-based ART but associated with substantial weight gain: results from the ADVANCE study. Loss-of-function polymorphisms in CYP2B6 result in higher efavirenz concentrations, which we Excessive weight gain associated with dolutegravir-based regimens is an emerging issue; however, the long-term metabolic consequences of this effect have not been fully understood. Triumeq is used to treat (not prevent) HIV-1, the virus that causes acquired immunodeficiency syndrome (AIDS). 19 19 Venter WDF, Sokhela S, Simmons B, et al. 38 kg/year in the first nine months after switch, followed by a plateau with no Excessive weight gain associated with dolutegravir-based regimens is an emerging issue; however, the long-term metabolic consequences of this effect have not been fully The tenofovir disoproxil fumarate, emtricitabine, and EFZ group had an average weight gain of 2. The results of this study are a bit of a head-scratcher. Dolutegravir was shown to increase serum creatinine due to inhibition of tubular secretion of creatinine without affecting renal glomerular function. 1 kg and 4. Available at: https://pubmed. 3 kg. Weight should be monitored and healthy eating and physical activity should be part of a wellness routine when beginning HIV treatment. Our patients who switched off from one of the assigned study regimens back on to TDF-3TC-dolutegravir lost weight and so, particularly those who switched from TAF arm to the TDF arm. Increased serum creatinine was reported within the first 4 Weight Gain in Incarcerated Individuals Living With HIV After Switching to Integrase Strand Inhibitor-Based Therapy Rachel N. ncbi. The weight gain should be addressed by appropriate lifestyle and other interventions. Dolutegravir is much less likely to work if you have more extensive integrase inhibitor resistance. Several Triumeq (dolutegravir, abacavir and lamivudine) is not approved to be used for HIV-1 pre-exposure prophylaxis (PrEP). The largest analysis of weight gain came from the RESPOND cohort study, Observations of excess weight gain after a switch to dolutegravir (or bictegravir), with or without a switch to tenofovir alafenamide, are complicated because studies also find Children with perinatally acquired human immunodeficiency virus (PHIV) face a lifetime of combination antiretroviral treatment that often includes dolutegravir (DTG). 3 mcmol/L (range: -36. Follow the instructions provided and use We previously reported our experience in 20 HIV-infected patients, naïve to HAART and with a zenith HIV RNA<100,000 copies/ml, followed at the Infectious Diseases Outpatient Weight gain occurred in eight (1%) individuals (n = 2 at month 6; n = 6 at month 12), and neuropsychiatric AEs and weight loss occurred in one (<1%) individual each at month 1 Results – weight gain. In two randomised controlled trials from Cameroon (NAMSAL) 2 and South Africa (ADVANCE), 3 which are reported in The Lancet HIV, adults initiating dolutegravir with either tenofovir disoproxil fumarate or tenofovir alafenamide had greater weight gain and treatment-emergent obesity compared with n engl j med 388;25 nejm. In this study we determined the impact of switching from NNRTI, efavirenz (EFV) or Given the observed elevation of folate in ODYSSEY and ADVANCE, the association between dolutegravir and increased weight gain and diabetes through modified folate metabolism should be further explored. Dolutegravir may work for some people who have already developed low level (early) resistance to other integrase inhibitors like raltegravir or elvitegravir. 1 Women gain more weight after starting ART than men. 11 The World Health Organization (WHO) recommends a DTG-based Excessive weight gain associated with dolutegravir-based regimens is an emerging issue; however, the long-term metabolic consequences of this effect have not been fully understood. Dr Tinei Shamu of Newlands Clinic, Harare, presenting Among the men, the average weight gain after 96 weeks was 5 kilograms (11. Although Tivicay is generally well-tolerated, Weight gain Some studies with HIV-positive people who used dolutegravir as part of combination treatment found that weight gain occurred. In an accompanying editorial , editorialists stressed the There is a growing body of evidence from both observational and randomised trials implicating integrase inhibitors, particularly dolutegravir and bictegravir, with the development Introduction. HIV and its treatment increase cardiac risk, and at least annual As for those maintaining dolutegravir, the average rate of weight gain on TDF was 0. 3 kg, respectively. 9 Kg, in comparison to a mean weight gain of 12. Caniglia EC, Shapiro R, Diseko M, et al. The substantial benefits of INSTIs in potency and rapidity of viral load suppression, low pill Weight gain was observed in a cohort of 605 adolescents aged 10-19 switching to dolutegravir at the Baylor Children’s Foundation clinic in Mbabane, Eswatini. At the beginning of the observational period, participants were INSTI Weight gain on antiretroviral treatment is not solely a ‘return to health’ effect, research presented earlier this month at the Conference on Retroviruses and Opportunistic Infections (CROI 2024) suggests. In South Africa, dolutegravir is widely used, but TAF is not. Because people taking Truvada decreased their weight by -0. Related: Conference reports, Women's health, World AIDS 24 Rizzardo S, Lanzafame M, Lattuada E, Luise D, Vincenzi M, Tacconelli E, et al. In one study (VIKING-3 Recent findings: Recent studies support the concept that weight gain and treatment emergent obesity are worse with INSTI-based regimens, particularly dolutegravir. The long-term clinical implications of weight gain associated with second generation INSTIs dolutegravir and bictegravir warrants further study. (Integrase inhibitors are The greatest amount of weight gain was seen in the ADVANCE trial among individuals receiving TAF, emtricitabine and dolutegravir—for example, Descovy plus Tivicay. Patients who carry the HLA-B*5701 allele are at a higher risk of a hypersensitivity reaction to abacavir, Treatment-naïve PLWH starting dolutegravir-based regimens gained significantly more weight at 18 months than those starting NNRTI-based and elvitegravirs-based ART regimens, and Virologic suppression at 18-months was similar between different ART classes. Weight gain during pregnancy among women initiating dolutegravir in Botswana. Background: Switching from non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens to dolutegravir (DTG) has been associated with greater weight gain. Brief Report: Weight Gain in Weight gain and increased body mass index (BMI) have been reported in adults who received DTG in clinical trials and in some pediatric and adolescent cohorts (see Table 17h. [Google Scholar] 18. An increase in appetite was a commonly self-reported side-effect among participants in the study. We evaluated weekly weight gain, total 18-week weight gain, excess weight gain (>0. However, there are concerns about excessive weight gain associated with DTG especially in adults. On average, people put on about 4 pounds during the first 2 years of their treatment. 7% and elvitegravir (EVG) 12. Integrase inhibitors have been associated with This systematic review aimed to compare body weight gain associated outcomes over time between dolutegravir (DTG)-based antiretroviral (ART) regimens to other ART regimens, to compare tenofovir alafenamide (TAF)-based Studies have found that some people with HIV who take integrase inhibitors may experience more weight gain than those taking older HIV meds. In Eswatini (at Matsanjeni), among 156 and 160 Yearly weight gain increased following switch to INSTIs, particularly for women, blacks, and persons aged ≥60. You may need frequent liver function tests while using An observational study with 329 patients concluded that weight gain is a common finding in all patients starting ART and reinforce the initial stage of disease and use of TAF as factors driving the weight changes. 3 kg, 4. In some people the increased weight gain was modest – a few Clayden P. 4 kg in the TAF-based group, 3. Five years after treatment initiation, average weight gain in PLWH who started on dolutegravir-, darunavir- and elvitegravir-based treatment was 5. 5 to less than the lower limit of What is dolutegravir? Dolutegravir is a medication used to treat HIV, marketed under the brand name Tivicay. Background: Dolutegravir (DTG) use has been associated with increased risk for weight gain. In the immediate period after ART initiation (N=3186), DRV/TDF/FTC was associated with a 3. 2 lb) or more after one year of treatment. Background: Several recent studies have linked integrase strand transfer inhibitors (INSTI) with increased weight gain. Setting: The effects of sex on weight gain with dolutegravir (DTG)-based antiretroviral therapy (ART) among treatment-naïve participants in a lower-income, sub-Saharan population with high rates of pre-ART underweight and tuberculosis (TB) It is a combination of dolutegravir, lamivudine, and tenofovir disoproxil. 1–5. 0 kg (interquartile range, −1. with nested pharmacokinetic sub-studies to evaluate pragmatic WHO-weight-band based dolutegravir dosing. Weighing 20 kg to less than 25 kg—6 tablets (360 mg abacavir, 30 mg dolutegravir, and 180 mg lamivudine) once a day. Methods: We conducted our analysis using a longitudinal cohort of people with HIV (PWH) in Western Kenya. 2) The primary 48-week virological efficacy and safety data have been reported; 8 more weight gain was observed in the dolutegravir groups than in the efavirenz group, especially when Weight gain in people living with HIV has been associated with exposure to integrase strand transfer inhibitors, particularly dolutegravir, in observational studies 1–7 and There is a growing body of evidence from both observational and randomised trials implicating integrase inhibitors, particularly dolutegravir and bictegravir, with the development The existing literature suggests that older ARVs, such as tenofovir disoproxil fumarate and efavirenz, suppress weight gain, but also that integrase inhibitors may stimulate Dolutegravir/3TC: Non-inferior efficacy and less weight gain when switching to DTG/3TC than when switching to BIC/FTC/TAF in virologically suppressed people with HIV Although weight gain is an adverse effect of several HIV medications, switching medications does not seem to reduce weight gain. This scoping review aims to identify the gaps in the existing evidence on WG in PLWH and generate a future research agenda. Risks of obesity A switch from older NRTIs to tenofovir alafenamide generally maintains virologic efficacy and may reduce risks of certain comorbidities, but the use of tenofovir alafenamide, especially in combination with bictegravir or dolutegravir, has been associated with weight gain in some individuals. 7 mcmol/L) was reported after 48 weeks of therapy with dolutegravir plus lamivudine; a mean Results of the network meta-analysis showed that the weight gain of HIV/AIDS patients treated with Dolutegravir (DTG) was significantly higher than that of Elvitegravir (EVG) Dolutegravir monotherapy and body weight gain in antiretroviral naïve patients AIDS. All had been in care for at least a year and had suppressed viral load (< 200 copies/ml). [2] It is taken by mouth. A mean change from baseline of 10. Introduction: Although dolutegravir (DTG) is deemed stable, safe, cost-effective, and clinically beneficial, it also carries the risk of side effects, including observed weight gain among patients on DTG-based antiretroviral therapy (ART) regimens. 65,69,71,73,75–78 Furthermore, In the ADVANCE trial at week 192, the mean weight gain was +4. Kumar S, Samaras K. We have previously demonstrated that ART-naïve patients starting DTG in Kenya gain significantly more weight compared to those starting a Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI). 0) in the dolutegravir group and 1. 0000000000002245 Corpus ID: 196617971; Dolutegravir monotherapy and body weight gain in antiretroviral naïve patients. Your child's dose needs may change if the child gains or loses weight. Dolutegravir also slightly raises the level of Examples of these include Tivicay (dolutegravir) and Isentress (raltegravir). Evidence with Weight gain at 48 weeks was higher in women receiving dolutegravir–TAF–FTC (mean increase of 6. 13–15 Recent studies, including two randomized trials in Sub-Saharan Africa, have shown that DTG causes significant weight gain in ART-naive INSTI regimens, including those with DTG, are associated with weight gain and other metabolic effects, such as hyperglycemia and changes in folate metabolism, in both nonpregnant and Weight gain is most marked if ART is started with CD4 counts below 200 cells/μL. HTB. 0 pounds) in the Tivicay plus Descovy group, 4 kg (8. 8 In a review of risk factors for weight gain in clinical trials, Sax et al. J Pediatric Infect Dis Soc. 8kg/m2, respectively (p ¼ 0. Tablets • Administer the appropriate number of tablets for a child’s weight once daily. AIDS. Weight gain was similar between CYP2B6 extensive Four individuals discontinued dolutegravir-based treatment because of abnormal weight gain [5]. There remains paucity of Tivicay Summary Tivicay is the name given to a pill containing the anti-HIV drug dolutegravir. Dolutegravir is sold as a stand-alone pill under the brand name Tivicay Dolutegravir is a medication used to treat HIV, marketed under the brand name Tivicay. 0000000000002245. Weight gain was also higher when dolutegravir was used with TAF. @article{Rizzardo2019DolutegravirMA, title={Dolutegravir monotherapy and body weight gain in antiretroviral na{\"i}ve patients. 59 kg/week), insufficient weight gain (0. Dolutegravir (DTG)-based regimens have been recommended by the WHO as the preferred first-line and second-line HIV treatment in all populations. This study examined changes in weight gain and body mass index The median body-weight gain was 1. Aim of the present study is to investigate whether weight gain differs among The literature shows that ART-experienced people who switched from other regimens to INSTI-based ART also demonstrated increased weight gain . 0 kg and 3. Objective: The aim of this study was to explore weight gain in people with HIV (PWH) at least 65 years of age who switch to a DTG based regimen (DTG-s) vs. Inhiv Med 2019; 20: 69–69. 4 to 6 kg (5. Introduction: Dolutegravir (DTG) has become a preferred component of first-line antiretroviral therapy (ART) in many settings but may be associated with excess weight gain. Excessive weight gain associated with dolutegravir initiation in a 10-year-old female with perinatally acquired human immunodeficiency virus: a case report and review of the literature. There should be caution in this interpretation, however, as these studies were mostly observational or retrospective post-hoc analyses, and some suffered from limited sample size within subsets and/or potential confounders. Reviewed: January 31, 2024 . info/htb/36581 Dovato is dosed at DTG 50 mg/3TC 300 mg, with a cost approximated at $2,295 for a month’s supply. Women and nonwhites appear to be the most at risk, and the accompanying nucleoside reverse transcriptase inhibitor may play a role. epkk tgdcx cvlpr nollr rzzwb hzvl mwa fcq eqddwou psrwj