{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T02:21:56Z","timestamp":1779243716785,"version":"3.51.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"3-4","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["Y1\u2013AI\u20135072"],"award-info":[{"award-number":["Y1\u2013AI\u20135072"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Defense Health Program, U.S. Department of Defense","award":["HU0001190002"],"award-info":[{"award-number":["HU0001190002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,26]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Weight gain and obesity in people living with HIV have been associated with increased risk for non-AIDS-related comorbidities, and integrase strand transfer inhibitor (INSTI)-based regimens may lead to comparatively more weight gain than other regimens. We evaluated body mass index (BMI) following antiretroviral therapy (ART) initiation among participants in the U.S. Military HIV Natural History Study (NHS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>NHS participants with available baseline weight and height data initiating ART from 2006 to 2017 were considered for analysis. Antiretroviral therapy was categorized by anchor class to include INSTIs, non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs). Linear growth-curve modeling was used to predict BMI changes from ART initiation through 2 years of follow-up in participants stratified by baseline BMI (&amp;lt;25 vs\u2009\u226525 kg\/m2) at ART start and anchor drug class. These models were adjusted for demographic- and HIV-related characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 961 NHS participants started on initial ART between 2006 and 2017, 491 men who had available baseline BMI data and were virally suppressed (&amp;lt;200 c\/mL) at 1 and 2 years of follow-up were included. Overall, the predicted BMI increased at each time point over 2 years regardless of baseline BMI. There was a trend toward less weight gain for non-INSTI regimens regardless of demographic- or HIV-related factors (\u22120.65 kg\/m2\/yr, P\u2009=\u2009.070). In participants with BMI\u2009&amp;lt;25, all regimens were associated with BMI gains except in those with high viral load (\u2265100,000 copies\/mL) started on PI regimens (\u22121.91 kg\/m2\/yr, P\u2009=\u2009.000; n\u2009=\u200913). For those participants with BMI\u2009\u226525, only INSTI- and PI-based regimens were significantly associated with increased BMI (INSTI 0.54 kg\/m2\/y, P\u2009=\u2009.000; PI 0.39 kg\/m2\/yr, P\u2009=\u2009.006). Non-nucleoside reverse transcriptase inhibitors were not associated with weight gain regardless of race- or HIV-related characteristics. African Americans with BMI\u2009\u226525 were more likely to gain weight as compared to Whites (0.99 kg\/m2\/yr, P\u2009=\u2009.016). Specific anchor drug-based predictions revealed that only INSTI use among African Americans was significantly associated with BMI gains (1.85 kg\/m2\/yr, P\u2009=\u2009.007); NNRTI- and PI-related weight change was not significant as compared to Whites.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In our cohort of young military members with HIV infection, those with BMI\u2009&amp;lt;25 experienced BMI gains across all ART classes. Among those with BMI\u2009\u226525, African Americans on INSTI regimens had the greatest BMI gains. Further studies are needed to determine whether NNRTI regimens should be considered in certain individuals at risk for INSTI-associated weight gain.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaa416","type":"journal-article","created":{"date-parts":[[2020,10,31]],"date-time":"2020-10-31T18:21:06Z","timestamp":1604168466000},"page":"279-285","source":"Crossref","is-referenced-by-count":4,"title":["Antiretroviral Therapy Anchor-based Trends in Body Mass Index Following Treatment Initiation Among Military Personnel with HIV"],"prefix":"10.1093","volume":"186","author":[{"suffix":"USAF, MC","given":"Maj David A","family":"Kline","sequence":"first","affiliation":[{"name":"Brooke Army Medical Center, Houston, TX 78234, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"MS","given":"Colton","family":"Daniels","sequence":"additional","affiliation":[{"name":"University of Texas at San Antonio, San Antonio, TX 78249, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"PhD","given":"Xiaohe","family":"Xu","sequence":"additional","affiliation":[{"name":"University of Texas at San Antonio, San Antonio, TX 78249, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"PhD","given":"Thankam","family":"Sunil","sequence":"additional","affiliation":[{"name":"University of Texas at San Antonio, San Antonio, TX 78249, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"MD","given":"Anuradha","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD 20852, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA"},{"name":"Walter Reed National Military Medical Center, Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"MD","given":"Brian K","family":"Agan","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD 20852, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"MD","given":"Rhonda E","family":"Colombo","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD 20852, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA"},{"name":"Madigan Army Medical Center, Tacoma, WA 98431, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"MC, USN","given":"Karl C","family":"Kronmann","sequence":"additional","affiliation":[{"name":"Naval Medical Center, Portsmouth, VA 23708, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"USA, MC","given":"Jason M","family":"Blaylock","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center, Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"USAF, MC","given":"Jason F","family":"Okulicz","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD 20852, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"USA, MC","given":"A Elizabeth","family":"Markelz","sequence":"additional","affiliation":[{"name":"Brooke Army Medical Center, Houston, TX 78234, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"issue":"2","key":"2021022620021290800_R1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.amepre.2014.08.033","article-title":"Overweight and obesity trends among active duty military personnel: a 13-year perspective","volume":"48","author":"Reyes-Guzman","year":"2015","journal-title":"Am J Prev Med"},{"issue":"7","key":"2021022620021290800_R2","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1002\/oby.21513","article-title":"Obesity and associated adverse health outcomes among US military members and veterans: findings from the millennium cohort study","volume":"24","author":"Rush","year":"2016","journal-title":"Obesity (Silver Spring)"},{"issue":"9","key":"2021022620021290800_R3","first-page":"9","article-title":"Update: diagnoses of overweight and obesity, active component, U.S. Armed Forces, 2011-2015","volume":"23","author":"Clark","year":"2016","journal-title":"MSMR"},{"issue":"6","key":"2021022620021290800_R4","doi-asserted-by":"crossref","first-page":"e163","DOI":"10.1016\/j.amepre.2015.10.015","article-title":"BMI and lower extremity injury in U.S. Army Soldiers, 2001-2011","volume":"50","author":"Hruby","year":"2016","journal-title":"Am J Prev Med"},{"issue":"2","key":"2021022620021290800_R5","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4278\/0890-1171-22.2.120","article-title":"Cost associated with being overweight and with obesity, high alcohol consumption, and tobacco use within the military health system\u2019s TRICARE prime-enrolled population","volume":"22","author":"Dall","year":"2007","journal-title":"Am J Health Promot"},{"key":"2021022620021290800_R6","volume-title":"Unhealthy and unprepared","author":"Maxey","year":"2018"},{"issue":"4","key":"2021022620021290800_R7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0010106","article-title":"Increasing rates of obesity among HIV-infected persons during the HIV epidemic","volume":"5","author":"Crum-Cianflone","year":"2010","journal-title":"PLoS One"},{"issue":"5","key":"2021022620021290800_R8","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/QAI.0000000000001722","article-title":"Body mass index and the risk of serious non-AIDS events and all-cause mortality in treated HIV-positive individuals: D:A:D cohort analysis","volume":"78","author":"Achhra","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"4","key":"2021022620021290800_R9","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/hiv.12294","article-title":"Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study","volume":"17","author":"Achhra","year":"2016","journal-title":"HIV Med"},{"issue":"2","key":"2021022620021290800_R10","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/QAI.0000000000001071","article-title":"Weight gain and incident diabetes among HIV-infected veterans initiating antiretroviral therapy compared with uninfected individuals","volume":"73","author":"Herrin","year":"2016","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2021022620021290800_R11","article-title":"Integrase strand transfer inhibitors are associated with weight gain in women","author":"Kerchberger","year":"2019"},{"issue":"44","key":"2021022620021290800_R12","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000005227","article-title":"Physical fitness characteristics of active duty US Air Force members with HIV infection","volume":"95","author":"De","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"2021022620021290800_R13","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1089\/aid.2015.0147","article-title":"Rising obesity prevalence and weight gain among adults starting antiretroviral therapy in the United States and Canada","volume":"32","author":"Koethe","year":"2016","journal-title":"AIDS Res Hum Retroviruses"},{"issue":"8","key":"2021022620021290800_R14","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1093\/jac\/dky145","article-title":"Obesity following ART initiation is common and influenced by both traditional and HIV-\/ART-specific risk factors","volume":"73","author":"Bakal","year":"2018","journal-title":"J Antimicrob Chemother"},{"issue":"4","key":"2021022620021290800_R15","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofx239","article-title":"Weight gain: a possible side effect of all antiretrovirals","volume":"4","author":"Taramasso","year":"2017","journal-title":"Open Forum Infect Dis"},{"issue":"3","key":"2021022620021290800_R16","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1089\/aid.2012.0234","article-title":"Short communication: from wasting to obesity: initial antiretroviral therapy and weight gain in HIV-infected persons","volume":"29","author":"Lakey","year":"2013","journal-title":"AIDS Res Hum Retroviruses"},{"issue":"1","key":"2021022620021290800_R17","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S2055-6640(20)30277-6","article-title":"Are new antiretroviral treatments increasing the risks of clinical obesity?","volume":"5","author":"Hill","year":"2019","journal-title":"J Virus Erad"},{"key":"2021022620021290800_R18","article-title":"Predictors of severe weight\/body mass index gain following antiretroviral initiation","author":"Bhagwat","year":"2017"},{"issue":"6","key":"2021022620021290800_R19","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1093\/cid\/ciz999","article-title":"Weight gain following initiation of antiretroviral therapy: risk factors in randomized comparative clinical trials","volume":"71","author":"Sax","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"4","key":"2021022620021290800_R20","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25484","article-title":"Weight gain among treatment-na\u00efve persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada","volume":"23","author":"Bourgi","year":"2020","journal-title":"J Int AIDS Soc"},{"issue":"10","key":"2021022620021290800_R21","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1097\/QAD.0000000000001495","article-title":"Dolutegravir and weight gain: an unexpected bothering side effect?","volume":"31","author":"Menard","year":"2017","journal-title":"AIDS"},{"issue":"7","key":"2021022620021290800_R22","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1093\/cid\/ciz407","article-title":"Greater weight gain in treatment naive persons starting dolutegravir-based antiretroviral therapy","volume":"70","author":"Bourgi","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2021022620021290800_R23","article-title":"Differential BMI changes following PI- and INSTI-based ART initiation by sex and race","author":"Bedimo","year":"2019"},{"key":"2021022620021290800_R24","article-title":"Risk factors for weight gain following switch to integrase inhibitor-based antiretroviral therapy","volume":"ciaa177","author":"Lake","year":"2020","journal-title":"Clin Inf Dis"},{"issue":"9","key":"2021022620021290800_R25","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1056\/NEJMoa1902824","article-title":"Dolutegravir plus two different prodrugs of Tenofovir to treat HIV","volume":"381","author":"Venter","year":"2019","journal-title":"N Engl J Med"},{"issue":"2","key":"2021022620021290800_R26","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/15248371003699969","article-title":"Twelve frequently asked questions about growth curve modeling","volume":"11","author":"Curran","year":"2010","journal-title":"J Cogn Dev"},{"issue":"2","key":"2021022620021290800_R27","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofu040","article-title":"Obesity trends and body mass index changes after starting antiretroviral treatment: the Swiss HIV Cohort Study","volume":"1","author":"Hasse","year":"2014","journal-title":"Open Forum Infect Dis"},{"issue":"7","key":"2021022620021290800_R28","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.3851\/IMP2348","article-title":"HIV infection and obesity: where did all the wasting go?","volume":"17","author":"Tate","year":"2012","journal-title":"Antivir Ther"},{"issue":"8","key":"2021022620021290800_R29","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1093\/cid\/cir510","article-title":"Long-term treatment with raltegravir or efavirenz combined with tenofovir\/emtricitabine for treatment-naive human immunodeficiency virus-1-infected patients: 156-week results from STARTMRK","volume":"53","author":"Rockstroh","year":"2011","journal-title":"Clin Infect Dis"},{"issue":"2","key":"2021022620021290800_R30","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1089\/aid.2011.0275","article-title":"Lopinavir\/ritonavir combined with raltegravir or tenofovir\/emtricitabine in antiretroviral-naive subjects: 96-week results of the PROGRESS study","volume":"29","author":"Reynes","year":"2013","journal-title":"AIDS Res Hum Retroviruses"},{"issue":"12","key":"2021022620021290800_R31","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1093\/cid\/civ193","article-title":"Comparison of the metabolic effects of ritonavir-boosted darunavir or atazanavir versus raltegravir, and the impact of ritonavir plasma exposure: ACTG 5257","volume":"60","author":"Ofotokun","year":"2015","journal-title":"Clin Infect Dis"},{"issue":"5","key":"2021022620021290800_R32","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/QAI.0000000000001525","article-title":"Brief report: weight gain in persons with HIV switched from Efavirenz-based to integrase strand transfer inhibitor-based regimens","volume":"76","author":"Norwood","year":"2017","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"9","key":"2021022620021290800_R33","first-page":"2","article-title":"Review of the U.S. military\u2019s human immunodeficiency virus program: a legacy of progress and a future of promise","volume":"24","author":"Okulicz","year":"2017","journal-title":"MSMR"},{"issue":"(13)","key":"2021022620021290800_R34","doi-asserted-by":"crossref","first-page":"366","DOI":"10.15585\/mmwr.mm6913a2","article-title":"Antiretroviral therapy and viral suppression among active duty service members with incident HIV infection\u2014United States, January 2012-June 2018","volume":"69","author":"Stahlman","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/186\/3-4\/279\/36392036\/usaa416.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/186\/3-4\/279\/36392036\/usaa416.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T20:02:40Z","timestamp":1614369760000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/186\/3-4\/279\/5948051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,26]]},"references-count":34,"journal-issue":{"issue":"3-4","published-online":{"date-parts":[[2021,2,26]]},"published-print":{"date-parts":[[2021,2,26]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaa416","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2021,2,26]]}}}