Initial Antiretroviral Regimens and Weight Gain

Some people with HIV have excessive weight gain after initiating antiretroviral therapy (ART); women and Black people are at greatest risk. Some studies link weight gain to tenofovir alafenamide (TAF) or integrase inhibitors, like dolutegravir or bictegravir. Once weight gain has occurred, switching ART regimens does not help. To evaluate the impact of initial regimens on weight gain, investigators with partial industry support randomized 600 adults in South Africa to either TAF-emtrecitabine (FTC)-dolutegravir or tenofovir disoproxil fumarate (TDF)-lamivudine (3TC)-doravirine. Almost all of the participants were Black Africans; two thirds were women.