Weight gain is a known complication of HIV treatment. However, the specific risk factors and magnitude are not well understood, especially after the initial treatment period. The objectives of this study were (1) to describe the demographic, clinical, and treatment characteristics of treatment-experienced adults with virally-suppressed HIV that had ≥3% annual weight gain in recent years (2013 to 2018) and (2) to identify variables independently associated with such gain.
EMR and prescription data were collected for the most recent ART exceeding 1 year in length for 3,468 previously-treated adult patients with continued HIV suppression. Patients resided in 21 States + DC and were in care at 6 HIV treatment centers. Data inclusion required ≥1 BMI at ARV prescription and ≥1 BMI during treatment but after 365 days up to 730 days. The resultant observation window was Aug 2013 to Aug 2018 and represented 5,459 patient years. Bivariate comparisons were made using chi-square or Fisher’s tests followed by independent variable assessment via logistic regression (LR).
Among the 3,468 adults, annualized weight gain was ≥3% for 1,045 (30%). Compared to those with <3% weight gain, the group with ≥3% gain had higher proportions of underweight and normal BMI at baseline, female, age <50, and psychiatric disorders and lower rates of comorbidities CKD, CVD, DM, hyperlipidemia, and hypogonadism. [TABLE] The weight gain patients were less commonly treated with PI-containing ART and more commonly treated with InSTI-containing ART. Factors identified as negatively associated with weight gain via LR were overweight or obese at baseline, hypogonadism, and use of PI-containing therapies. Psychiatric disorders were positively associated with weight gain via LR. InSTI-containing ART was not significantly associated with weight gain in the LR.
Weight gain in the treatment-experienced population with continued HIV suppression was primarily associated with lower BMI, reduced proportion of hypogonadism, increased proportion of psychiatric disorders, and non-PI-containing regimens. The association between InSTI-based ART and weight gain, which reached significance in bivariate analyses, did not remain significant in LR, suggesting that in this population, weight changes are primarily driven by other factors.