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Body weight was measured annually, with significant weight gain defined as a \u226510% increase between consecutive measurements or compared to baseline. Gut microbiota profiling was conducted using 16S rRNA sequencing (V3\u2013V4 regions) via the Illumina MiSeq platform.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>202 participants were recruited, with 169 completing the 240-week follow-up. Among these, 63 remained on INSTI-based, 79 on NNRTI-based and 27 on NNRTI\u200a+\u200aINSTI-based regimens. Median (interquartile range (IQR)) 5-year weight gain was 1.3 (\u22122.8 to 4.5)\u2005kg. Significant weight gain occurred in 70 (34.7%) participants, including 20 (9.9%) with \u226510% gain between consecutive measurements and 50 (24.8%) from baseline. No significant differences were observed in adjusted \u03b1- and \u03b2-diversity indices between groups defined by weight gain. Adjusted analysis of compositions of microbiomes with bias correction 2 model showed that weight gain was associated with the genera Dialister and Tyzzerella_4, whereas Phascolarctobacterium was enriched in those without significant weight gain. While overall weight gain did not differ between INSTI-based and NNRTI-based groups, participants on INSTIs-based regimens showed higher relative abundances of bacteria linked to weight gain, like Tyzzerella_4 (0.05% versus 0.02%, P\u200a=\u200a0.017) and Lactobacillus (0.29% versus 0.22%, P\u200a=\u200a0.009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant weight gain in the PWH is associated with distinct gut microbiota profiles. The enrichment of weight gain-associated taxa, such as Tyzzerella_4 and Lactobacillus, in individuals on INSTI-based regimens suggests a potential microbiota-mediated mechanism modulating metabolic outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf182","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T09:41:36Z","timestamp":1747993296000},"page":"2145-2157","source":"Crossref","is-referenced-by-count":4,"title":["Gut microbiota and weight gain in people with HIV on integrase inhibitors: a five-year longitudinal study"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5217-3726","authenticated-orcid":false,"given":"Javier","family":"Garc\u00eda-Abell\u00e1n","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Hospital General Universitario de Elche and Universidad Miguel Hern\u00e1ndez de Elche , Alicante ,","place":["Spain"]},{"name":"CIBER de Enfermedades Infecciosas 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Jos\u00e9","family":"Gosalbes","sequence":"additional","affiliation":[{"name":"Genomics and Health Area, Fundaci\u00f3n para el Fomento de la Investigaci\u00f3n Sanitaria y Biom\u00e9dica de la Comunitat Valenciana, Valencia, and CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP) , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9949-8504","authenticated-orcid":false,"given":"Marta","family":"Fern\u00e1ndez-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]},{"name":"Infectious Diseases Unit, Hospital General Universitario de Elche , Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Alicante 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