Blood pressure, weight change and incident hypertension after switching to dolutegravir in treatment-experienced people living with HIV.

IF 3.1 2区医学 Q3 IMMUNOLOGY

AIDS Pub Date : 2025-07-24 DOI:10.1097/QAD.0000000000004309

Hans-Michael Steffen, Evelyn Viola, Agness Thawani, Layout G Kachere, Jacqueline Huwa, Claudia Wallrauch, Philipp Kasper, Florian Neuhann, Tom Heller, Volker Winkler, Ethel Rambiki, Melani R Mahanani

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引用次数: 0

Abstract

Objective: Dolutegravir (DTG) is recommended in WHO guidelines and has reportedly been associated with excess gain in body weight (BW).

Design: In the prospective LighTen Cohort Study (ClinicalTrials.gov NCT02381275) we evaluated changes in BW and blood pressure (BP) of people living with HIV (PLHIV) who had initiated tenofovir (TDF)/lamivudine (3TC)/efavirenz (EFV; TLE). Follow-up continued after participants had been switched to TDF/3TC/DTG (TLD) in 2019.

Methods: From the electronic medical record system, we retrieved data on BW and systolic BP of LighTen Cohort Study participants (age ≥18 years), who were still in care. We modelled BW and systolic BP over time utilizing interrupted time series (ITS) considering repeated measurements and adjusting for age and sex. Incident hypertension was defined as office BP ≥140/90 mmHg using ≥2 measurements on ≥2 consecutive visits.

Results: Data of 543 PLHIV (317 females) were analysed. ITS showed an increase in BW of 1.24 kg/year on TLE with a minimal contribution (36.5 g/year) during DTG treatment, in contrast to the change in systolic BP: 0.33mmHg/year on TLE vs. 2.63mmHg/year on DTG. Incident hypertension in previously normotensive PLHIV was confirmed in 5.4% (while on TLE) versus 11.0% (while on TLD).

Conclusions: Following the initial increase in BW on TLE, a larger increase in BP and a higher risk of incident hypertension was associated with switching antiretroviral therapy from TLE to TLD. Focussing on BP control while on DTG and timely initiation of antihypertensive drug therapy can help to reduce the burden of hypertension in PLHIV with their inherent increased cardiovascular risk.

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有治疗经验的艾滋病毒感染者改用多替格拉韦后的血压、体重变化和高血压发生率。

目的：Dolutegravir （DTG）是世卫组织指南中推荐的药物，据报道与体重（BW）的过度增加有关。设计：在一项前瞻性的light队列研究（ClinicalTrials.gov NCT02381275）中，我们评估了开始使用替诺福韦(TDF)/拉米夫定(3TC)/依非韦伦（EFV）治疗的HIV感染者（PLHIV）体重和血压的变化；框架)。在参与者于2019年切换到TDF/3TC/DTG （TLD）后，继续进行随访。方法：从电子病历系统中检索仍在照护的light队列研究参与者（年龄≥18岁）的体重和收缩压数据。考虑到重复测量并调整年龄和性别，我们利用中断时间序列（ITS）对体重和收缩压随时间的变化进行建模。突发高血压的定义是：连续就诊≥2次，测量≥2次办公室血压≥140/90 mmHg。结果：对543例PLHIV患者（女性317例）资料进行分析。ITS显示，TLE组体重增加1.24 kg/年，DTG组贡献最小（36.5 g/年），而收缩压变化：TLE组0.33mmHg/年，DTG组2.63mmHg/年。先前血压正常的PLHIV患者确认发生高血压的比例为5.4% （TLE组），而11.0% （TLD组）。结论：在TLE初始BW升高后，从TLE转为TLD的抗逆转录病毒治疗与更大的BP升高和更高的高血压发生风险相关。在控制血压的同时重视DTG，及时开始抗高血压药物治疗，有助于减轻PLHIV患者高血压负担，其固有的心血管风险增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

期刊介绍： Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.