Observational studyAIDS (London, England)2025
Body weight changes in people with HIV starting dolutegravir versus efavirenz-based regimens in a large cohort in rural Tanzania.
Observational study in AIDS (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- 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
- Virologic, immunologic, and metabolic outcomes and mortality in people with HIV on bictegravir/emtricitabine/tenofovir alafenamide fumarate versus dolutegravir-based antiretroviral therapies: a retrospective multicenter cohort study in China.The Lancet regional health. Western Pacific · 2026Article
- Longitudinal analysis of metabolic changes in people with HIV on integrase inhibitor-based versus efavirenz-based therapy: a prospective real-world cohort study in China.BMC infectious diseases · 2026Article
- Drug induced liver injury in HIV patients on dolutegravir based antiretroviral therapy regimens in Wolaita Sodo comprehensive specialized hospital.Scientific reports · 2025Article
- "I Don't Have Time to Exercise": Determinants of Physical Activity and Diet Consumption Among Adolescents Living with HIV in Southern Tanzania - A Phenomenological Qualitative Study.HIV/AIDS (Auckland, N.Z.) · 2025Article
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Authors and funding
13 authors.
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Abstract
objectivesTo analyze weight changes associated with dolutegravir- versus efavirenz-based antiretroviral therapy (ART) in people with HIV (PWH) in rural Tanzania, where undernutrition is prevalent.
designLongitudinal, observational study of the prospective Kilombero and Ulanga Antiretroviral Cohort (KIULARCO).
methodsWe included adult, ART-naïve, nonpregnant PWH initiating efavirenz-based ART 12/2016-02/2019 or dolutegravir-based ART 03/2019-12/2022. We used multivariable linear mixed-effects models to assess adjusted weight changes during 18 months after ART start and Cox regression models to assess factors associated with incident obesity, weight gain ≥10% and hypertension.
resultsOf 1205 PWH at ART start [median age 40 years (interquartile range (IQR) 32-48); 719 (59.7%) females], 166 (13.8%) individuals were underweight and 317 (26.3%) overweight/obese; 621 (51.5%) initiated efavirenz-based and 584 (48.5%) dolutegravir-based ART. After 18 months, estimated weight gain was 5.1 kg [95% confidence interval (CI) 4.7-5.5] in the dolutegravir versus 4.0 kg (95% CI 3.7-4.4) in the efavirenz group. The weight gain difference between treatment groups was high in men (1.7 kg (95% CI 0.8-2.6; P < 0.001)), in those aged 30-49 years (1.5 kg (0.8-2.1); P < 0.001) and those with CD4 + cell count ≥500/ul (2.5 kg (1.4-3.7), P < 0.001)). Cumulative obesity incidence at 18 months was 10.9% (95% CI 8.3-14.0) in the dolutegravir and 5.1% (95% CI 3.6-7.1) in the efavirenz group. Associated factors were dolutegravir and a pre-ART body mass index (BMI) of 25-29 kg/m 2 . Dolutegravir and age, but not weight gain were associated with incident of hypertension.
conclusionsDolutegravir-based ART was associated with more weight gain, higher obesity and hypertension - especially in those with a higher pre-ART BMI compared to efavirenz-based regimens.
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