Alternative first-line HIV regimen limits excess weight gain
A South African study presented at the International AIDS Conference indicates that HIV treatment regimens containing doravirine and TDF result in less weight gain compared to those with dolutegravir and TAF. The findings highlight the challenge of managing side effects in long-term HIV care.
Why it matters
Weight gain is a significant concern for patients on antiretroviral therapy, and identifying regimens with fewer side effects improves long-term health outcomes.
Starting treatment with a regimen containing doravirine and tenofovir disoproxil (TDF) resulted in less weight gain than starting treatment with a regimen containing dolutegravir and tenofovir alafenamide, a South African study reported yesterday week at the 26th International AIDS Conference in Rio de Janeiro, Brazil.
The available evidence suggests that weight gain can occur after starting antiretroviral treatment regardless of the drugs in the regimen. Studies consistently show that weight gain is greater in women and Black populations, especially when taking tenofovir alafenamide (TAF) in combination with an integrase inhibitor, such as dolutegravir or bictegravir.
Attempts to reverse weight gain by switching away from these drugs have been largely unsuccessful. However, prevention of significant weight gain when starting HIV treatment may be more achievable than reversal after weight gain is established.
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