Journal
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
Volume 85, Issue 3, Pages 355-362Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAI.0000000000002447
Keywords
HIV; INSTI; ART; diabetes mellitus; BP; hypertension
Categories
Funding
- National Heart, Lung, and Blood Institute (NHLBI)
- 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)
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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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(2)). 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.
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