{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:50:49Z","timestamp":1791474649265,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Weight gain is an increasingly recognized concern among people receiving antiretroviral therapy (ART) and may increase the risk of non\u2010communicable diseases. Integrase inhibitors (INSTIs) such as dolutegravir (DTG) have been associated with weight gain, but the metabolic effects of long\u2010acting cabotegravir (CAB\u2010LA), another INSTI, for HIV treatment and prevention remain incompletely characterized. We conducted a systematic review to synthesize evidence on weight and body mass index (BMI) changes associated with CAB\u2010LA\u2010based regimens across ART and pre\u2010exposure prophylaxis (PrEP) trials.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We systematically searched major biomedical databases, Medline, Embase, Cochrane CENTRAL, supplemented by Google Scholar and proceedings from key HIV conferences to identify grey literature for randomized controlled trials that evaluated CAB\u2010LA as PrEP or CAB\u2010LA\u2010based regimen as ART between 01st January 2010 to 01st August 2025, with no language restrictions. Two reviewers independently screened studies, extracted data and assessed risk of bias using the Cochrane Risk of Bias 2.0 tool. Given substantial heterogeneity in outcome reporting across studies, evidence was synthesized narratively following the Synthesis Without Meta\u2010analysis (SWiM) guidance. Findings were summarized by intervention type (PrEP or ART), sex\/gender and geographical setting.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 1998 records identified, 234 were removed as duplicates, 1764 were screened at title and abstract level, and 42 full\u2010text articles were assessed. This resulted in 11 reports from eight randomized controlled trials, with follow\u2010up ranging from 41 to 185\u2009weeks. Overall, weight remained stable or only increased modestly in both intervention and comparator groups across studies. Among HIV\u2010negative individuals receiving CAB\u2010LA for PrEP, weight gain was observed in both intervention and comparator groups, with no consistent evidence of excess weight gain attributable to CAB\u2010LA. In HPTN 077, weight gain was similar between CAB\u2010LA and placebo recipients, while HPTN 083 and HPTN 084 reported annualized weight gains ranging from 1.23 to 2.4\u2009kg\/year in CAB\u2010LA recipients and 0.37 to 2.1\u2009kg\/year in comparator groups. Among people living with HIV receiving ART, weight changes at 48\u2009weeks ranged from \u22120.4 to +1.8\u2009kg with CAB\u2010LA plus long\u2010acting rilpivirine (RPV\u2010LA) and 0.0 to +1.5\u2009kg with comparator regimens, with no consistent evidence of greater weight gain in the CAB\u2010LA plus RPV\u2010LA arms. Only one trial among ART\u2010experienced adults in Africa (CARES) reported greater weight gain with CAB\u2010LA plus RPV\u2010LA than with continued oral therapy (mean weight gain 1.5\u2009kg vs. 0.0\u2009kg, respectively), with more pronounced effects in women compared to men (2.1\u2009kg vs. \u22120.2\u2009kg). The overall risk of bias was low to moderate.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n CAB\u2010LA\u2010based regimens were associated with only small increases in weight in both the prevention and treatment of HIV, with no consistent evidence of excess weight gain relative to standard comparators. Continued monitoring will be important as long\u2010acting antiretroviral therapies are scaled up, particularly among women and individuals from Africa.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hiv.70319","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:57:11Z","timestamp":1791471431000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A systematic review of evidence on weight change following initiation of long\u2010acting cabotegravir for the prevention or treatment of\n HIV<\/scp>"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2467-4037","authenticated-orcid":false,"given":"Jonathan","family":"Kitonsa","sequence":"first","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute (MRC\/UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Entebbe Uganda"},{"name":"Department of Global Health and Infection Brighton and Sussex Medical School, The University of Sussex Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0975-0728","authenticated-orcid":false,"given":"Ronald","family":"Komata","sequence":"additional","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute (MRC\/UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Entebbe Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilber","family":"Ssembajjwe","sequence":"additional","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute (MRC\/UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Entebbe Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8001-6544","authenticated-orcid":false,"given":"Daniel","family":"Grint","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5285-3622","authenticated-orcid":false,"given":"Julian","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Global Health and Infection Brighton and Sussex Medical School, The University of Sussex Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7291-1693","authenticated-orcid":false,"given":"Eugene","family":"Ruzagira","sequence":"additional","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute (MRC\/UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Entebbe Uganda"},{"name":"London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3211-163X","authenticated-orcid":false,"given":"Robert","family":"Kalyesubula","sequence":"additional","affiliation":[{"name":"Department of Physiology College of Health Sciences, Makerere University Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1165-0573","authenticated-orcid":false,"given":"Jaime","family":"Vera","sequence":"additional","affiliation":[{"name":"Department of Global Health and Infection Brighton and Sussex Medical School, The University of Sussex Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5070-532X","authenticated-orcid":false,"given":"Fiona","family":"Cresswell","sequence":"additional","affiliation":[{"name":"Medical Research Council\/Uganda Virus Research Institute (MRC\/UVRI) and London School of Hygiene and Tropical Medicine (LSHTM) Entebbe Uganda"},{"name":"Department of Global Health and Infection Brighton and Sussex Medical School, The University of Sussex Brighton UK"},{"name":"London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2023.102255","article-title":"The burden of non\u2010communicable diseases among people living with HIV in sub\u2010Saharan Africa: a systematic review and meta\u2010analysis","volume":"65","author":"Moyo\u2010Chilufya M","year":"2023","journal-title":"EClinicalMedicine"},{"issue":"9","key":"e_1_2_8_3_1","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 WDF","year":"2019","journal-title":"New Engl J 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during the dolutegravir transition in the African cohort study","volume":"25","author":"Esber AL","year":"2022","journal-title":"J Int AIDS Soc"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ijid.2021.07.030","article-title":"Long\u2010term weight gain after initiating combination antiretroviral therapy in treatment\u2010na\u00efve Asian people living with human immunodeficiency virus","volume":"110","author":"Ando N","year":"2021","journal-title":"Int J Infect Dis"},{"issue":"6","key":"e_1_2_8_9_1","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 PE","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"9","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"e471","DOI":"10.1093\/cid\/ciaa177","article-title":"Risk factors for weight gain 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