Background

Excessive weight gain is a current concern among People Living with HIV (PLHIV) starting ART.

Objectives

To evaluate the weight gain after 48-weeks of ART in naive patients, according with baseline CD4 count.

Methods

PLHIV starting 3TC + TDF + DTG with at least 48-weeks of follow up in two AIDS referral centers were stratified by baseline CD4 count (lower or higher than 200 cells/mm³). Data on CD4 count, HIV viral load, weight/Body Mass Index (BMI), lipids and glucose levels were collected at baseline, 24 and 48 weeks of treatment. For analysis purpose, patients were categorized according to their BMI progression.

Results

A total of 270 patients were included in the study. Mean CD4 count were 78.3 ± 61.7 and 536.7 ± 273 cells/mm³ for low and high CD4 count groups, respectively (p < 0.001). Baseline BMI was significantly lower in low CD4 group (21.7 vs. 23.6 Kg/m², p < 0.001). Patients in low CD4 group gained more weight than those in high CD4 group (11.2 ± 8.5 kg vs. 2.2 ± 4.2 Kg, p = 0.004). Overall weight gain was higher in women, regardless group (13.1 ± 7.9 Kg vs. 1.4 ± 3.6 Kg for women and men, respectively, p < 0.001). The proportion of overweight/obesity significantly increased in low CD4 group. Viral suppression rate was high for both groups. At week 48 the overall proportion of overweight/obesity was like that reported for the Brazilian population.

Conclusions

Weight gain in the present study indicates a “return to health” phenomenon. Excessive weight gain was more frequent in women.

中文翻译：

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48 周随访后，根据基线 CD4 计数，开始基于多替拉韦的 ART 患者体重增加

背景

体重过度增加是开始接受抗逆转录病毒治疗的艾滋病毒感染者 (PLHIV) 当前面临的一个问题。

目标

根据基线 CD4 计数评估初次接受 ART 48 周的患者体重增加情况。

方法

在两个 AIDS 转诊中心开始 3TC + TDF + DTG 并进行至少 48 周随访的 PLHIV 根据基线 CD4 计数（低于或高于 200 个细胞/mm ³）进行分层。在基线、治疗 24 周和 48 周时收集 CD4 计数、HIV 病毒载量、体重/体重指数 (BMI)、血脂和血糖水平的数据。出于分析目的，根据患者的 BMI 进展对患者进行分类。

结果

该研究总共纳入了 270 名患者。低 CD4 计数组和高 CD4 计数组的平均 CD4 计数分别为 78.3 ± 61.7 和 536.7 ± 273 个细胞/mm ^{3 (} p < 0.001)。低CD4组的基线BMI显着较低（21.7 vs. 23.6 Kg/m ²，p < 0.001）。低 CD4 组的患者比高 CD4 组的患者体重增加更多（11.2 ± 8.5 kg vs. 2.2 ± 4.2 Kg，p  = 0.004）。无论哪组，女性的总体体重增加均较高（女性和男性分别为 13.1 ± 7.9 Kg 与 1.4 ± 3.6 Kg，p < 0.001）。低CD4组超重/肥胖比例显着增加。两组的病毒抑制率均较高。第 48 周时，超重/肥胖的总体比例与巴西人口的报告相同。

结论

本研究中的体重增加表明“恢复健康”现象。体重过度增加在女性中更为常见。