ArticleJournal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada2025
Can switching to doravirine/lamivudine/tenofovir DF halt or reverse INSTI-associated weight gain?
Article in Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: In randomized trials, doravirine (DOR) appears relatively weight-neutral, while tenofovir DF (TDF) may be weight-suppressive. Here we designed a prospective, observational pilot study to assess the impact of switching to DOR/3TC/TDF on weight trajectory in patients with significant integrase inhibitor (INSTI)-associated weight gain. Methods: Adults with a ≥10% increase in body weight while on an INSTI (± tenofovir alafenamide) regimen and HIV RNA <50 copies/mL were switched to DOR/3TC/TDF for 12 months. Weight, waist circumference, and routine bloodwork were measured at baseline and every 12 weeks. Total body fat (DXA scan) and body image/self-esteem (B-WISE, modified Fat Redistribution and Metabolic Change in HIV questionnaires) were assessed at baseline and week 48. The target enrolment was 25 participants. Results: Between September 2021 and September 2023, four participants were enrolled, with the results available for three women (Black, age 51/56/70 years, BMI 45.3/33.9/30.8 kg/m Conclusions: Two out of three Black women with a ≥10% INSTI-associated increase in body weight had weight loss of >5% after switching to DOR/3TC/TDF for 48 weeks. All three participants experienced small improvements in waist circumference, body fat, and metabolism, and all reported improvements in body image/self-esteem. Pandemic challenges significantly impacted the ability to enrol participants.
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