Background Excess weight gain has been reported in some adults on dolutegravir (DTG), but data in children/adolescents living with human immunodeficiency virus (CALHIV) are limited. Methods CALHIV aged 2-17 years at DTG start from 15 observational cohorts across Europe and Thailand were included. Mixed models described changes in body-mass-index-for-age z-score (zBMI). We assessed (1) zBMI change 48 weeks before versus after DTG start; (2) zBMI change up to 96 weeks on DTG and associated factors; and (3) zBMI changes over 96 weeks in CALHIV aged 6-17 years at start of DTG versus protease inhibitor (PI)-based regimens using propensity score weighting. Results Of 948 CALHIV on DTG (>99% HIV-1, <1% HIV-2), 50% were female, the median age was 13.7 (interquartile range [IQR], 11.1-15.6]) years, median zBMI was 0.31 (IQR, -0.64 to 1.19), 48% were Black, and 30% were overweight or obese at DTG start. Among 741 participants with zBMI available before and after DTG start, zBMI (95% confidence interval (CI) increased by 0.07 (.03-.11) versus 0.13 (.09-.16) (P =. 087), in the 48 weeks before and after DTG start, respectively. Mean zBMI change by 96 weeks on DTG was 0.20 (95% CI. 14-.27). In multivariable models, greatest increases in zBMI were in those aged 6-11 years at DTG start (0.34 [95% CI. 23-.44]), males of "other"ethnicity (0.39 [95% CI. 10-.68]), Black females (0.27 [95% CI. 15-.39]), and those on tenofovir alafenamide (TAF) (0.39 [95% CI. 17-.61]). There was no difference in mean zBMI change at 96 weeks among those on DTG- versus PI-based regimens (0.21 [95% CI. 13-.30] vs 0.30 [95% CI. 13-.48]; P =. 354). Conclusions CALHIV experienced zBMI increases on DTG with the largest gains in children aged 6-11 years, on TAF, with low baseline zBMI, and some variation by sex and ethnicity. However, zBMI changes over 96 weeks were comparable between those on DTG- and PI-based regimens.

Changes in Body Mass Index in Children and Adolescents Living with Human Immunodeficiency Virus in Europe and Thailand Starting Dolutegravir / Chappell E., Crichton S., Collins I.J., Valle G.D., Duff C., Edgar K., Giaquinto C., Jackson C., Judd A., Mangiarini L., O'Rourke J., Scott K., Thorne C., Goetghebuer T., Hainaut M., Tremerie W., Delforge M., Hoffmann T.U., Nordly S.B., Braun M.B., et al.. - In: OPEN FORUM INFECTIOUS DISEASES. - ISSN 2328-8957. - ELETTRONICO. - 12:(2025), pp. ofaf640.0-ofaf640.0. [10.1093/ofid/ofaf640]

Changes in Body Mass Index in Children and Adolescents Living with Human Immunodeficiency Virus in Europe and Thailand Starting Dolutegravir

Galli L.;Chiappini E.;
2025

Abstract

Background Excess weight gain has been reported in some adults on dolutegravir (DTG), but data in children/adolescents living with human immunodeficiency virus (CALHIV) are limited. Methods CALHIV aged 2-17 years at DTG start from 15 observational cohorts across Europe and Thailand were included. Mixed models described changes in body-mass-index-for-age z-score (zBMI). We assessed (1) zBMI change 48 weeks before versus after DTG start; (2) zBMI change up to 96 weeks on DTG and associated factors; and (3) zBMI changes over 96 weeks in CALHIV aged 6-17 years at start of DTG versus protease inhibitor (PI)-based regimens using propensity score weighting. Results Of 948 CALHIV on DTG (>99% HIV-1, <1% HIV-2), 50% were female, the median age was 13.7 (interquartile range [IQR], 11.1-15.6]) years, median zBMI was 0.31 (IQR, -0.64 to 1.19), 48% were Black, and 30% were overweight or obese at DTG start. Among 741 participants with zBMI available before and after DTG start, zBMI (95% confidence interval (CI) increased by 0.07 (.03-.11) versus 0.13 (.09-.16) (P =. 087), in the 48 weeks before and after DTG start, respectively. Mean zBMI change by 96 weeks on DTG was 0.20 (95% CI. 14-.27). In multivariable models, greatest increases in zBMI were in those aged 6-11 years at DTG start (0.34 [95% CI. 23-.44]), males of "other"ethnicity (0.39 [95% CI. 10-.68]), Black females (0.27 [95% CI. 15-.39]), and those on tenofovir alafenamide (TAF) (0.39 [95% CI. 17-.61]). There was no difference in mean zBMI change at 96 weeks among those on DTG- versus PI-based regimens (0.21 [95% CI. 13-.30] vs 0.30 [95% CI. 13-.48]; P =. 354). Conclusions CALHIV experienced zBMI increases on DTG with the largest gains in children aged 6-11 years, on TAF, with low baseline zBMI, and some variation by sex and ethnicity. However, zBMI changes over 96 weeks were comparable between those on DTG- and PI-based regimens.
2025
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Chappell E.; Crichton S.; Collins I.J.; Valle G.D.; Duff C.; Edgar K.; Giaquinto C.; Jackson C.; Judd A.; Mangiarini L.; O'Rourke J.; Scott K.; Thorne...espandi
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1454398
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