{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:16:23Z","timestamp":1789654583597,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T00:00:00Z","timestamp":1693180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015631","name":"Merck Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015631","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The effect of antiretroviral therapy (ART), particularly integrase strand transfer inhibitors (INSTIs), on non\u2010alcoholic fatty liver disease (NAFLD) in people with HIV remains unclear. We evaluated the effect of switching non\u2010INSTI backbone antiretroviral medications to raltegravir on NAFLD and metabolic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This was a single\u2010centre, phase IV, open\u2010label, randomized controlled clinical trial. People living with HIV with NAFLD and undetectable viral load while receiving a non\u2010INSTI were randomized 1:1 to the switch arm (raltegravir 400\u2009mg twice daily) or the control arm (continuing ART regimens not containing INSTI). NAFLD was defined as hepatic steatosis by controlled attenuation parameter \u2265238\u2009dB\/m in the absence of significant alcohol use and viral hepatitis co\u2010infections. Cytokeratin 18 was used as a biomarker of non\u2010alcoholic steatohepatitis. Changes over time in outcomes were quantified as standardized mean differences (SMDs), and a generalized linear mixed model was used to compare outcomes between study arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 31 people with HIV (mean age 54\u2009years, 74% male) were randomized and followed for 24\u2009months. Hepatic steatosis improved between baseline and end of follow\u2010up in both the switch (SMD \u221243.4\u2009dB\/m) and the control arm (\u221226.6\u2009dB\/m); the difference between arms was not significant. At the end of follow\u2010up, aspartate aminotransferase significantly decreased in the switch arm compared with the control arm (SMD \u22129.4 vs. 5.5\u2009IU\/L). No changes in cytokeratin 18, body mass index, or lipids were observed between study arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Switching to a raltegravir\u2010based regimen improved aspartate aminotransferase but seemed to have no effect on NAFLD, body weight, and lipids compared with remaining on any other ART.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13531","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T06:58:15Z","timestamp":1693292295000},"page":"135-142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Switch to a raltegravir\u2010based antiretroviral regimen in people with <scp>HIV<\/scp> and non\u2010alcoholic fatty liver disease: A randomized controlled trial"],"prefix":"10.1111","volume":"25","author":[{"given":"Mohamed","family":"Shengir","sequence":"first","affiliation":[{"name":"Division of Experimental Medicine McGill 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