PMID- 33927086
OWN - NLM
STAT- MEDLINE
DCOM- 20210806
LR  - 20230921
IS  - 1473-5571 (Electronic)
IS  - 0269-9370 (Linking)
VI  - 35
IP  - 10
DP  - 2021 Aug 1
TI  - Implications of weight gain with newer anti-retrovirals: 10-year predictions of 
      cardiovascular disease and diabetes.
PG  - 1657-1665
LID - 10.1097/QAD.0000000000002930 [doi]
AB  - OBJECTIVE: To evaluate the long-term risks of type 2 diabetes mellitus (T2DM) and 
      cardiovascular disease (CVD) secondary to weight gain and clinical obesity 
      associated with the initiation of integrase strand transfer inhibitors and 
      tenofovir alafenamide (TAF) in the ADVANCE trial using validated risk equation 
      tools. DESIGN: Retrospective data analysis. METHODS: In ADVANCE, 1053 
      treatment-naive participants in South Africa (99% black, 59% female) were 
      randomized to 96 weeks of TAF/emtricitabine + dolutegravir (TAF/FTC + DTG), 
      tenofovir disoproxil fumarate/FTC + DTG (TDF/FTC + DTG), or TDF/FTC + efavirenz 
      (TDF/FTC/EFV). The 5 and 10-year risks of CVD were calculated using D:A:D, QRISK 
      and Framingham, and T2DM risk using QDiabetes, Cambridge Diabetes and Leicester 
      Practice Risk scores. Participants were included in this analysis if they were 
      above 30 years old at baseline. RESULTS: A total of 217 (TAF/FTC + DTG), 218 
      (TDF/FTC + DTG), and 215 (TDF/FTC/EFV) participants had 96-week data available. 
      Weight gain was +8.1, +4.2, and +2.4 kg on TAF/FTC + DTG, TDF/FTC + DTG, and 
      TDF/FTC/EFV, respectively. Participants on TAF/FTC + DTG had greatest risk scores 
      for CVD (using QRISK) and T2DM, driven by weight changes. Differences were 
      statistically significant between TAF/FTC + DTG and TDF/FTC/EFV for CVD risk 
      using the QRISK equation, equivalent to one extra case per 1000 people treated 
      over 10 years, and between all treatment groups for T2DM risk. Six extra T2DM 
      cases were predicted on TAF/FTC + DTG vs. TDF/FTC + DTG using QDiabetes. 
      CONCLUSION: Obesity, especially with TAF/FTC + DTG, drove increased risk of T2DM, 
      with some evidence of greater CVD risk. However, predictive tools have not been 
      validated in the HIV-positive and black African population.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - McCann, Kaitlyn
AU  - McCann K
AD  - School of Public Health, Imperial College London, London.
FAU - Shah, Shahini
AU  - Shah S
AD  - School of Public Health, Imperial College London, London.
FAU - Hindley, Laura
AU  - Hindley L
AD  - School of Public Health, Imperial College London, London.
FAU - Hill, Andrew
AU  - Hill A
AD  - Department of Translational Medicine, Liverpool University, Pharmacology, 
      Liverpool.
FAU - Qavi, Ambar
AU  - Qavi A
AD  - School of Public Health, Imperial College London, London.
FAU - Simmons, Bryony
AU  - Simmons B
AD  - Department of Infectious Disease, Imperial College London, London, UK.
FAU - Serenata, Celicia
AU  - Serenata C
AD  - Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, 
      Johannesburg, South Africa.
FAU - Sokhela, Simiso
AU  - Sokhela S
AD  - Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, 
      Johannesburg, South Africa.
FAU - Venter, Willem D F
AU  - Venter WDF
AD  - Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, 
      Johannesburg, South Africa.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
RN  - 0 (Anti-HIV Agents)
RN  - G70B4ETF4S (Emtricitabine)
SB  - IM
MH  - Adult
MH  - *Anti-HIV Agents/therapeutic use
MH  - *Cardiovascular Diseases/chemically induced/epidemiology
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy
MH  - Emtricitabine/therapeutic use
MH  - Female
MH  - *HIV Infections/complications/drug therapy
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - South Africa/epidemiology
MH  - Weight Gain
EDAT- 2021/05/01 06:00
MHDA- 2021/08/07 06:00
CRDT- 2021/04/30 06:12
PHST- 2021/05/01 06:00 [pubmed]
PHST- 2021/08/07 06:00 [medline]
PHST- 2021/04/30 06:12 [entrez]
AID - 00002030-202108010-00015 [pii]
AID - 10.1097/QAD.0000000000002930 [doi]
PST - ppublish
SO  - AIDS. 2021 Aug 1;35(10):1657-1665. doi: 10.1097/QAD.0000000000002930.