Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Efavirenz Pharmacogenetics and Weight Gain Following Switch to Integrase Inhibitor-Containing Regimens.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 51 citations in OpenAlex.
- Initiation of dolutegravir vs efavirenz on 12- and 24-month weight, body mass index, blood pressure, and incident hypertension: A target trial emulation.Annals of epidemiology · 2026Trial
- Melanocortin-4 Receptor Gene Variants and Weight Change Following Switch to Integrase Inhibitor-Based Antiretroviral Therapy.Open forum infectious diseases · 2025Trial
- Weight Changes and Adverse Pregnancy Outcomes With Dolutegravir- and Tenofovir Alafenamide Fumarate-Containing Antiretroviral Treatment Regimens During Pregnancy and Postpartum.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Virological and metabolic outcomes after switching to dolutegravir or rilpivirine in virologically suppressed adults with HIV in Thailand: an open-label, randomised, controlled, non-inferiority trial.The Lancet regional health. Southeast Asia · 2026Article
- Pharmacovigilance study of INSTIs associated with weight gain and glucose/lipid metabolism adverse events based on the FDA adverse event reporting system.HIV medicine · 2026Article
- Long-Term Effectiveness and Tolerability of Dolutegravir/Lamivudine in Korea: A 3-Year Follow Up Study.Infection & chemotherapy · 2026Article
- Menopause is associated with faster increases in insulin resistance in women with HIV.AIDS (London, England) · 2026Article
- Article
- Immunometabolic and RAAS determinants of circulating interferon gamma in an HIV and TB Zambian cohort.Discover public health · 2026Article
- Article
- Differential effects of switching to integrase strand transfer inhibitors on the gut microbiota and markers of HIV disease progression.BMC microbiology · 2025Article
- Switch to Integrase Strand Transfer Inhibitors During the Menopausal Transition Is Associated With Accelerated Body Composition Change in Women With HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Short and Long-term Body Weight Change Following the Switch to or the Addition of Integrase Inhibitors in Persons With HIV Differs by Sex.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Body weight changes in people with HIV starting dolutegravir versus efavirenz-based regimens in a large cohort in rural Tanzania.AIDS (London, England) · 2025Observational
- Preswitch Regimens Associated With Weight Gain Among Persons With HIV who Switch to Integrase Inhibitor-Containing Regimens.Open forum infectious diseases · 2025Article
- Metabolic Complications Associated with Use of Integrase Strand Transfer Inhibitors (InSTI) for the Treatment of HIV-1 Infection: Focus on Weight Changes, Lipids, Glucose and Bone Metabolism.Current HIV/AIDS reports · 2024Review
- Weight Gain in HIV Adults Receiving Antiretroviral Treatment: Current Knowledge and Future Perspectives.Life (Basel, Switzerland) · 2024Review
- Weight Gain and Antiretroviral Therapy.Infectious disease clinics of North America · 2024Review
- Switch to fixed-dose ainuovirine, lamivudine, and tenofovir DFThe Lancet regional health. Western Pacific · 2024Article
- Weight Gain After HIV Therapy Initiation: Pathophysiology and Implications.The Journal of clinical endocrinology and metabolism · 2024 · on this mapReview
Corrections and comments
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Authors and funding
20 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundUnwanted weight gain affects some people living with human immunodeficiency virus (HIV) who are prescribed integrase strand transfer inhibitors (INSTIs). Mechanisms and risk factors are incompletely understood.
methodsWe utilized 2 cohorts to study pharmacogenetics of weight gain following switch from efavirenz- to INSTI-based regimens. In an observational cohort, we studied weight gain at 48 weeks following switch from efavirenz- to INSTI-based regimens among patients who had been virologically suppressed for at least 2 years at a clinic in the United States. Associations were characterized with CYP2B6 and UGT1A1 genotypes that affect efavirenz and INSTI metabolism, respectively. In a clinical trials cohort, we studied weight gain at 48 weeks among treatment-naive participants who were randomized to receive efavirenz-containing regimens in AIDS Clinical Trials Group studies A5095, A5142, and A5202 and did not receive INSTIs.
resultsIn the observational cohort (n = 61), CYP2B6 slow metabolizers had greater weight gain after switch (P = .01). This was seen following switch to elvitegravir or raltegravir, but not dolutegravir. UGT1A1 genotype was not associated with weight gain. In the clinical trials cohort (n = 462), CYP2B6 slow metabolizers had lesser weight gain at week 48 among participants receiving efavirenz with tenofovir disoproxil fumarate (P = .001), but not those receiving efavirenz with abacavir (P = .65). Findings were consistent when stratified by race/ethnicity and by sex.
conclusionsAmong patients who switched from efavirenz- to INSTI-based therapy, CYP2B6 genotype was associated with weight gain, possibly reflecting withdrawal of the inhibitory effect of higher efavirenz concentrations on weight gain. The difference by concomitant nucleoside analogue is unexplained.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.