Dolutegravir is not associated with weight gain in ART experienced geriatric patients living with HIV

OBJECTIVE: The aim of this study was to explore weight gain (WG) in people living with HIV (PLWH) ≥65 years who switch to a DTG based regimen (DTG-s) vs remaining INSTI-naive (INSTI-n) on stable ART.METHODS: This was a longitudinal prospective study of PLWH from the GEPPO cohort. At the beginning of the observational period, participants were INSTI-naives (INSTI-n). During follow-up, they were divided in two groups: INSTI-n vs dolutegravir-switchers (DTG-s) with no further change in ART. Body weight was assessed at baseline and at last follow-up visit. Significant weight gain was defined as an increase ≥5% of baseline weight from the first to the last visit. ART regimens were collected at each patients' visit. Kaplan-Meier curves were drawn to assess time to reach a WG >5%.RESULTS: Out of 568 PLWH (83.1% males, median age 69.5 years), 427 (75%) were INSTI-n and 141 (25%) DTG-s. After an average follow-up of 2.6 (±0.8) years, no significant change in body weight was observed both among INSTI-n (delta weight=0.02 (±7.5), p=0.633) and DTG-s (delta weight= -0.04 (±5.2), p=0.755). WG was also not significantly different between study groups (9.3% in INSTI-n and 15.1% in DTG-S: p = 0.175). No significant differences in time to achieve a WG greater or equal than 5% of baseline weight emerged in INSTI-n vs DTG-s (p = 0.93), two-drug regimens (2DR) vs three-drug regimens (3DR) (p = 0.56) or TAF vs TDF (p = 0.56).CONCLUSIONS: Results from a large Italian cohort did not show a significant WG associated with switch to DTG in PLWH 65 years of age or older. This finding emerged also when comparing 3DR vs 2DR and TAF exposed and unexposed geriatric PLWH.