Impact on weight of a Doravirine switch in people living with HIV.

IF 3.2 3区 医学 Q2 INFECTIOUS DISEASES
HIV Medicine Pub Date : 2025-09-30 DOI:10.1111/hiv.70123
Nina Garofoli, Philippe Flandre, Jean-Paul Vincensini, Quentin Richier, Priscille Couture, Karine Lacombe, Gilles Pialoux, Jean-Luc Meynard
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Abstract

Background and objective: Doravirine is among the first-line recommended treatments for people living with HIV (PLHIV) in the 2025 EACS guidelines. As opposed to tenofovir alafenamide or anti-integrase, its use was not associated with weight gain in clinical trials, but limited data are currently available in real life. In this cohort study, we investigated weight variation in PLHIV switching to doravirine.

Methods: A retrospective cohort analysis was conducted in two Parisian hospitals, including all PLHIV switching to doravirine between January 2019 and September 2022. Body Mass Index (BMI) variation was calculated from 48 months before to 36 months after the switch.

Results: Between January 2019 and December 2022, 300 patients were included, with 220 men (73%) and 185 (62%) patients born in France. The main antiretroviral combination before the switch was TAF/FTC/BIC (n = 47, 16%), and after the switch, doravirine with TDF and 3TC (n = 202, 67%). Twenty-eight patients (9.3%) discontinued doravirine after a median duration of 17.5 months. At 12 and 24 months after the switch, the median BMI variation was 0.0 kg/m2, and this variation remained unchanged regardless of the pre-switch treatment. These results were less pronounced in subgroups of patients originating from sub-Saharan Africa (+0.2 and +0.4 kg/m2) and in women (+0.3 and 0.5 kg/m2).

Conclusion: Switching to doravirine led to a weight stabilisation, without reversal of the previously gained weight. In PLHIV at higher risk of weight gain, there was still a slight increase in BMI after the doravirine switch.

多拉韦林转换对艾滋病毒感染者体重的影响
背景和目的:在2025年EACS指南中,多拉韦林是HIV感染者(PLHIV)的一线推荐治疗之一。与替诺福韦alafenamide或抗整合酶相反,在临床试验中,它的使用与体重增加无关,但目前在现实生活中可获得的数据有限。在这项队列研究中,我们调查了PLHIV改用多拉韦林后的体重变化。方法:在巴黎两家医院进行回顾性队列分析,包括2019年1月至2022年9月期间所有改用多拉韦林的PLHIV患者。身体质量指数(BMI)的变化计算从48个月前到36个月后的转换。结果:在2019年1月至2022年12月期间,纳入了300例患者,其中220例男性(73%)和185例(62%)出生在法国。切换前以TAF/FTC/BIC联合治疗为主(n = 47, 16%),切换后以doravirine联合TDF和3TC联合治疗为主(n = 202, 67%)。28名患者(9.3%)在中位持续时间17.5个月后停用多拉韦林。在转换后的12个月和24个月,BMI的中位数变化为0.0 kg/m2,无论转换前的治疗如何,这一变化都保持不变。这些结果在撒哈拉以南非洲患者亚组(+0.2和+0.4 kg/m2)和女性(+0.3和0.5 kg/m2)中不太明显。结论:改用多拉韦林导致体重稳定,未逆转先前增加的体重。在体重增加风险较高的PLHIV患者中,在改用多拉韦林后,BMI仍有轻微增加。
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
HIV Medicine
HIV Medicine 医学-传染病学
CiteScore
5.10
自引率
10.00%
发文量
167
审稿时长
6-12 weeks
期刊介绍: HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.
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