Metabolic Changes Associated With the Use of Integrase Strand Transfer Inhibitors Among Virally Controlled Women

Nathan A. Summers, Cecile D. Lahiri, Christine D. Angert, Amalia Aldredge, C. Christina Mehta, Ighovwerha Ofotokun, Anne M. Kerchberger, Deborah Gustafson, Sheri D. Weiser, Seble Kassaye, Deborah Konkle-Parker, Anjali Sharma, Adaora A. Adimora, Hector Bolivar, Jennifer Cocohoba, Audrey L. French, Elizabeth T. Golub, Anandi N. Sheth

Research output: Contribution to journalArticlepeer-review

Abstract

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/m). 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.

Original languageEnglish (US)
Pages (from-to)355-362
Number of pages8
JournalJournal of acquired immune deficiency syndromes (1999)
Volume85
Issue number3
DOIs
StatePublished - Nov 1 2020

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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