{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:30:16Z","timestamp":1791513016610,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Dolutegravir (DTG) has become a preferred component of first\u2010line antiretroviral therapy (ART) in many settings but may be associated with excess weight gain. We evaluated changes in weight and body mass index (BMI) after switch to single\u2010tablet tenofovir\/lamivudine\/dolutegravir (TLD) by people living with HIV (PLWH) in four African countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The African Cohort Study (AFRICOS) prospectively follows adults with and without HIV in Kenya, Uganda, Tanzania and Nigeria. Demographics, ART regimen, weight, BMI and waist\u2010to\u2010hip ratio were collected every 6 months. Multivariable Cox proportional hazards modelling was used to estimate hazard ratios and 95% confidence intervals (CIs) for factors associated with developing a BMI \u226525 kg\/m<jats:sup>2<\/jats:sup>. Linear mixed effects models with random effects were used to examine the average change in BMI, weight and waist\u2010to\u2010hip ratio.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 23 January 2013 to 1 December 2020, 2950 PLWH were enrolled in AFRICOS and 1474 transitioned to TLD. In adjusted models, PLWH on TLD had 1.77 times the hazard of developing a high BMI (95% CI: 1.22\u20132.55) compared to PLWH on non\u2010TLD ART. Examining change in weight among all PLWH on ART, participants on TLD gained an average of 0.68 kg (95% CI: 0.32\u20131.04) more than PLWH on other regimens after adjusting for duration on ART, sex, age, study site and CD4 nadir. Among participants who switched to TLD, the average change in weight prior to TLD switch was 0.35 kg\/year (95% CI: 0.25\u20130.46) and average change in weight was 1.46 kg\/year (95% CI: 1.18\u20131.75) in the year following transition to TLD after adjustment for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elevated BMI and weight gain among PLWH on TLD are concerning safety signals. Implications for the development of metabolic comorbidities should be monitored, particularly if annual weight gain persists during continued follow\u2010up after transitioning to TLD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25899","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T03:34:55Z","timestamp":1649907295000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Weight gain during the dolutegravir transition in the African Cohort Study"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5337-0126","authenticated-orcid":false,"given":"Allahna L.","family":"Esber","sequence":"first","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research  Silver Spring Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6944-5695","authenticated-orcid":false,"given":"David","family":"Chang","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research  Silver Spring Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Iroezindu","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research  Silver Spring Maryland USA"},{"name":"HJF Medical Research International  Abuja Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Bahemana","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research  Silver Spring Maryland USA"},{"name":"HJF Medical Research International  Mbeya Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Kibuuka","sequence":"additional","affiliation":[{"name":"Makerere University\u2010Walter Reed Project  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Owuoth","sequence":"additional","affiliation":[{"name":"U.S. Army Medical Research Directorate \u2013 Africa  Kisumu Kenya"},{"name":"HJF Medical Research International  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Singoei","sequence":"additional","affiliation":[{"name":"U.S. Army Medical Research Directorate \u2013 Africa  Kisumu Kenya"},{"name":"HJF Medical Research International  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonah","family":"Maswai","sequence":"additional","affiliation":[{"name":"U.S. Army Medical Research Directorate \u2013 Africa  Kisumu Kenya"},{"name":"HJF Medical Research International  Kericho Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8026-9901","authenticated-orcid":false,"given":"Nicole F.","family":"Dear","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research  Silver Spring Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5947-265X","authenticated-orcid":false,"given":"Trevor A.","family":"Crowell","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research  Silver Spring Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina S.","family":"Polyak","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research  Silver Spring Maryland USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Ake","sequence":"additional","affiliation":[{"name":"U.S. Military HIV Research Program Walter Reed Army Institute of Research  Silver Spring Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the AFRICOS Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12421"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare6010017"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001722"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001071"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz118"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00705"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz999"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2040622314530461"},{"key":"e_1_2_12_10_1","volume-title":"Supplement to the 2016 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection","year":"2018"},{"key":"e_1_2_12_11_1","volume-title":"Considerations for the introduction of TLD in national programs","author":"ICAP","year":"2018"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002250"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001845"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001525"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002379"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa177"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1904340"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky145"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy981"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy989"},{"key":"e_1_2_12_21_1","volume-title":"Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach","author":"World Health Organization","year":"2016"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa195"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz407"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0092-8674(00)81865-6"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmet.2017.06.015"},{"key":"e_1_2_12_26_1","unstructured":"European Medicines Agency.Assessment Report Tivicay International. Non\u2010proprietary name: dolutegravir.2013;73(7):e2153\u201063."},{"key":"e_1_2_12_27_1","article-title":"Efavirenz pharmacogenetics and weight gain following switch to integrase inhibitor\u2010containing regimens","author":"Leonard MA","year":"2020","journal-title":"Clin Infect Dis."},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.126675"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz853"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25899","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25899","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T22:01:03Z","timestamp":1692828063000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1002\/jia2.25899"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25899","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]},"assertion":[{"value":"2021-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25899"}}