{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:46:44Z","timestamp":1786978004766,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T00:00:00Z","timestamp":1686528000000},"content-version":"vor","delay-in-days":11,"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":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Integrase strand transfer inhibitor (INSTI)\u2010containing antiretroviral therapy (ART) has been associated with weight gain, though there is limited information on associations between ART\u2010related weight gain and cardiometabolic outcomes among people living with HIV\u20101 (PLWH). We, therefore, evaluated risks of incident cardiometabolic outcomes following INSTI versus non\u2010INSTI\u2010based ART initiation in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study using IBM MarketScan Research Databases (12 August 2012\u221231 January 2021). Treatment\u2010na\u00efve PLWH initiating ART (index date) on\/after 12 August 2013 (approval date of the first second\u2010generation INSTI, dolutegravir) were included and censored at regimen switch\/discontinuation, end of insurance eligibility or end of data availability. We used inverse probability of treatment weights constructed with baseline (12 months pre\u2010index) characteristics to account for differences between INSTI\u2010 and non\u2010INSTI\u2010initiating cohorts. Doubly robust hazard ratios (HRs) obtained from weighted multivariable Cox regression were used to compare time to incident cardiometabolic outcomes (congestive heart failure [CHF], coronary artery disease, myocardial infarction, stroke\/transient ischemic attack, hypertension, type II diabetes, lipid disorders, lipodystrophy and metabolic syndrome) by INSTI\u2010initiation status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Weighted INSTI (mean age = 39 years, 23% female, 70% commercially insured, 30% Medicaid insured) and non\u2010INSTI (mean age = 39 years, 24% female, 71% commercially insured, 29% Medicaid insured) cohorts included 7059 and 7017 PLWH, respectively. The most common INSTI\u2010containing regimens were elvitegravir\u2010based (43.4%), dolutegravir\u2010based (33.3%) and bictegravir\u2010based (18.4%); the most common non\u2010INSTI\u2010containing regimens were darunavir\u2010based (31.5%), rilpivirine\u2010based (30.4%) and efavirenz\u2010based (28.3%). Mean\u00b1standard deviation follow\u2010up periods were 1.5\u00b11.5 and 1.1\u00b11.2 years in INSTI\u2010 and non\u2010INSTI\u2010initiating cohorts, respectively. INSTI initiators were at a clinically and significantly increased risk of experiencing incident CHF (HR = 2.12, 95% confidence interval [CI] = 1.08\u22124.05;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.036), myocardial infarction (HR = 1.79, 95% CI = 1.03\u22125.65;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.036) and lipid disorders (HR = 1.26, 95% CI = 1.04\u22121.58;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.020); there was no evidence of an increased risk for other individual or composite outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over a short average follow\u2010up period of &lt;2 years, INSTI use among treatment\u2010na\u00efve PLWH was associated with an increased risk of several cardiometabolic outcomes, such as CHF, myocardial infarction and lipid disorders, compared to non\u2010INSTI use. Further research accounting for additional potential confounders and with longer follow\u2010up is warranted to more accurately and precisely quantify the impact of INSTI\u2010containing ART on long\u2010term cardiometabolic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26123","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T06:06:41Z","timestamp":1686550001000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Incidence of cardiometabolic outcomes among people living with HIV\u20101 initiated on integrase strand transfer inhibitor versus non\u2010integrase strand transfer inhibitor antiretroviral therapies: a retrospective analysis of insurance claims in the United States"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-9104","authenticated-orcid":false,"given":"Peter F.","family":"Rebeiro","sequence":"first","affiliation":[{"name":"Divisions of Infectious Diseases &amp; Epidemiology Department of Medicine Department of Biostatistics Vanderbilt University Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0060-765X","authenticated-orcid":false,"given":"Bruno","family":"Emond","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5801-6927","authenticated-orcid":false,"given":"Carmine","family":"Rossi","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brahim K.","family":"Bookhart","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs LLC Titusville New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi","family":"Shah","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Caron\u2010Lapointe","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc. 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