{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T17:50:43Z","timestamp":1794073843371,"version":"4.8.0"},"reference-count":100,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T00:00:00Z","timestamp":1689120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"HLB-SIMPLe Alliance"},{"DOI":"10.13039\/100000050","name":"National Heart, Lung and Blood Institute","doi-asserted-by":"publisher","award":["UG3HL156388"],"award-info":[{"award-number":["UG3HL156388"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"US Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Rapid advances in the potency, safety, and availability of modern HIV antiretroviral therapy (ART) have yielded a near-normal life expectancy for most people living with HIV (PLWH). Ironically, considering the history of HIV\/AIDS (initially called \u201cslim disease\u201d because of associated weight loss), the latest dilemma faced by many people starting HIV therapy is weight gain and obesity, particularly Black people, women, and those who commenced treatment with advanced immunodeficiency. We review the pathophysiology and implications of weight gain among PLWH on ART and discuss why this phenomenon was recognized only recently, despite the availability of effective therapy for nearly 30 years. We comprehensively explore the theories of the causes, from initial speculation that weight gain was simply a return to health for people recovering from wasting to comparative effects of newer regimens vs prior toxic agents, to direct effects of agents on mitochondrial function. We then discuss the implications of weight gain on modern ART, particularly concomitant effects on lipids, glucose metabolism, and inflammatory markers. Finally, we discuss intervention options for PLWH and obesity, from the limitations of switching ART regimens or specific agents within regimens, weight-gain mitigation strategies, and potential hope in access to emerging antiobesity agents, which are yet to be evaluated in this population.<\/jats:p>","DOI":"10.1210\/clinem\/dgad411","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T13:08:44Z","timestamp":1689080924000},"page":"e478-e487","source":"Crossref","is-referenced-by-count":60,"title":["Weight Gain After HIV Therapy Initiation: Pathophysiology and Implications"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7866-2651","authenticated-orcid":false,"given":"Nomathemba C","family":"Chandiwana","sequence":"first","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg 2193 , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3506-842X","authenticated-orcid":false,"given":"Mark J","family":"Siedner","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital and Harvard Medical School , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-4689","authenticated-orcid":false,"given":"Vincent C","family":"Marconi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Department of Global Health, Emory University School of Medicine and Rollins School of Public Health , Atlanta, GA 4223 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6494-7645","authenticated-orcid":false,"given":"Andrew","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Therapeutics, University of Liverpool , Liverpool L69 7BE , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7266-2503","authenticated-orcid":false,"given":"Mohammed K","family":"Ali","sequence":"additional","affiliation":[{"name":"Hubert Department of Global Health, Rollins School of Public Health, Emory University , Atlanta, GA 4223 , USA"},{"name":"Department of Family and Preventive Medicine, School of Medicine, Emory University , Atlanta, GA 30322 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5477-8585","authenticated-orcid":false,"given":"Rachel L","family":"Batterham","sequence":"additional","affiliation":[{"name":"Department of Medicine, University College London , London WC1E 6BT , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4157-732X","authenticated-orcid":false,"given":"Willem Daniel Francois","family":"Venter","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg 2193 , South Africa"},{"name":"Department of Public Health Medicine, Faculty of Health Sciences, School of Health Systems and Public Health, University of Pretoria , Pretoria 0028 , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"issue":"1","key":"2024011817404812700_dgad411-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1056\/NEJMp1916753","article-title":"Four decades of HIV\/AIDS\u2014much accomplished, much to do","volume":"383","author":"Fauci","year":"2020","journal-title":"N Engl J Med"},{"issue":"5","key":"2024011817404812700_dgad411-B2","doi-asserted-by":"crossref","first-page":"e295","DOI":"10.1016\/S2352-3018(23)00028-0","article-title":"Life expectancy after 2015 of adults with HIV on long-term 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