TY - JOUR
T1 - Metabolic Changes Associated With the Use of Integrase Strand Transfer Inhibitors Among Virally Controlled Women
AU - Summers, Nathan A.
AU - Lahiri, Cecile D.
AU - Angert, Christine D.
AU - Aldredge, Amalia
AU - Mehta, C. Christina
AU - Ofotokun, Ighovwerha
AU - Kerchberger, Anne M.
AU - Gustafson, Deborah
AU - Weiser, Sheri D.
AU - Kassaye, Seble
AU - Konkle-Parker, Deborah
AU - Sharma, Anjali
AU - Adimora, Adaora A.
AU - Bolivar, Hector
AU - Cocohoba, Jennifer
AU - French, Audrey L.
AU - Golub, Elizabeth T.
AU - Sheth, Anandi N.
N1 - Funding Information:
Supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (grant numbers UL1 TR002378, TL1 TR002382) to N.A.S.; National Institute of Allergy and Infectious Diseases (K23 AI124913) to C.D.L.
Funding Information:
Data in this article were collected by the MACS/WIHS Combined Cohort Study (MWCCS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). MWCCS (Principal Investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241-01; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201-01; Bronx CRS (Kathryn Anastos and Anjali Sharma), U01-HL146204-01; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202-01; Data Analysis and Coordination Center (Gypsyamber D'Souza, Stephen Gange, and Elizabeth Golub), U01-HL146193-01; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245-01; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240-01; Connie Wofsy Women's HIV Study, Northern California CRS (Bradley Aouizerat and Phyllis Tien), U01-HL146242-01; Los Angeles CRS (Roger Detels), U01-HL146333-01; Metropolitan Washington CRS (S.K. and Daniel Merenstein), U01-HL146205-01; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203-01; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208-01; UAB-MS CRS (Mirjam-Colette Kempf and Deborah Konkle-Parker), U01-HL146192-01; UNC CRS (Adaora Adimora), U01-HL146194-01. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional cofunding from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Human Genome Research Institute (NHGRI), National Institute on Aging (NIA), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute of Allergy And Infectious Diseases (NIAID), National Institute Of Neurological Disorders And Stroke (NINDS), National Institute Of Mental Health (NIMH), National Institute On Drug Abuse (NIDA), National Institute Of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), P30-AI-050409 (Atlanta CFAR), P30-AI-050410 (UNC CFAR), and P30-AI-027767 (UAB CFAR).
Publisher Copyright:
© 2020 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Background:Integrase strand transfer inhibitors (INSTIs) have been associated with weight gain among women living with HIV. We aimed to investigate the association between INSTIs and change in cardiometabolic risk indicators.Setting:Retrospective cohort.Methods:Data from 2006 to 2017 were analyzed from women living with HIV enrolled in the longitudinal Women's Interagency HIV Study who were virally controlled on antiretroviral therapy (ART) for ≥5 consecutive semiannual visits. Women who switched/added an INSTI to ART (INSTI group) were compared with women who remained on non-INSTI ART (non-INSTI group). Outcomes included changes in fasting lipids and glucose, hemoglobin A1c (HbA1c), blood pressure (BP), and incident diabetes, hypertension, and insulin resistance. Outcomes were measured 6-12 months before and 6-18 months after INSTI switch/add in the INSTI group with comparable visits in the non-INSTI group. Longitudinal linear regression models compared change over time in each outcome by the study group.Results:One thousand one hundred eighteen participants (234 INSTI, 884 non-INSTI) were followed for a median 2.0 (Q1 1.9, Q3 2.0) years. Participants were median age 49 years, 61% Black, and 73% overweight or obese (body mass index ≥25 kg/m2). Compared with non-INSTI, the INSTI group experienced greater increases in HbA1c (+0.05 vs. -0.06 mg/dL, P = 0.0318), systolic BP (+3.84 vs. +0.84 mm Hg, P = 0.0191), and diastolic BP (+1.62 vs. -0.14 mm Hg, P = 0.0121), with greatest change in HbA1c among women on INSTIs with ≥5% weight gain.Conclusions:INSTI use was associated with unfavorable changes in HbA1c and systolic and diastolic BP during short-term follow-up. Further research is needed to understand long-term cardiometabolic effects of INSTI use.
AB - Background:Integrase strand transfer inhibitors (INSTIs) have been associated with weight gain among women living with HIV. We aimed to investigate the association between INSTIs and change in cardiometabolic risk indicators.Setting:Retrospective cohort.Methods:Data from 2006 to 2017 were analyzed from women living with HIV enrolled in the longitudinal Women's Interagency HIV Study who were virally controlled on antiretroviral therapy (ART) for ≥5 consecutive semiannual visits. Women who switched/added an INSTI to ART (INSTI group) were compared with women who remained on non-INSTI ART (non-INSTI group). Outcomes included changes in fasting lipids and glucose, hemoglobin A1c (HbA1c), blood pressure (BP), and incident diabetes, hypertension, and insulin resistance. Outcomes were measured 6-12 months before and 6-18 months after INSTI switch/add in the INSTI group with comparable visits in the non-INSTI group. Longitudinal linear regression models compared change over time in each outcome by the study group.Results:One thousand one hundred eighteen participants (234 INSTI, 884 non-INSTI) were followed for a median 2.0 (Q1 1.9, Q3 2.0) years. Participants were median age 49 years, 61% Black, and 73% overweight or obese (body mass index ≥25 kg/m2). Compared with non-INSTI, the INSTI group experienced greater increases in HbA1c (+0.05 vs. -0.06 mg/dL, P = 0.0318), systolic BP (+3.84 vs. +0.84 mm Hg, P = 0.0191), and diastolic BP (+1.62 vs. -0.14 mm Hg, P = 0.0121), with greatest change in HbA1c among women on INSTIs with ≥5% weight gain.Conclusions:INSTI use was associated with unfavorable changes in HbA1c and systolic and diastolic BP during short-term follow-up. Further research is needed to understand long-term cardiometabolic effects of INSTI use.
KW - ART
KW - BP
KW - HIV
KW - INSTI
KW - diabetes mellitus
KW - hypertension
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U2 - 10.1097/QAI.0000000000002447
DO - 10.1097/QAI.0000000000002447
M3 - Article
C2 - 33060420
AN - SCOPUS:85093479891
SN - 1525-4135
VL - 85
SP - 355
EP - 362
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 3
ER -
