Weight Gain in People with HIV: The role of demographics, antiretroviral therapy, and lifestyle factors on weight

Yesha Patel, The Ohio State University Wexner Medical Center, 12306, 410 W 10th Avenue, Columbus, Ohio, United States, 43210; Yesha.Patel@osumc.edu.
Anjali Doshi, The Ohio State University College of Medicine and Public Health, 12305, Columbus, Ohio, United States; anjali.doshi@osumc.edu.
Anna Levesque, Maine Medical Center, 92602, Portland, Maine, United States; annalevesque22@gmail.com.
Shelsie Lindor, University of Rochester, 6927, Rochester, New York, United States; shelsie_lindor@URMC.Rochester.edu.
Robert Moranville, Scripps Health, 2697, San Diego, California, United States; moranviller@gmail.com.
Sheila Okere, Mayo Clinic in Florida, 156400, Jacksonville, Florida, United States; sheilaokere@gmail.com.
Danielle Robinson, The Ohio State University College of Medicine and Public Health, 12305, Columbus, Ohio, United States; danielle.robinson@osumc.edu.
Lauren Taylor, The University of Texas Southwestern Medical Center, 12334, Dallas, Texas, United States; laurenlt388@gmail.com.


We explored factors associated with weight gain among people with HIV (PWH) on antiretroviral therapy (ART) at The Ohio State University Wexner Medical Center (OSUWMC). This was a retrospective cohort study of adult PWH on ART for ≥3 months. Patients with CD4+ T cell count <200 cells>/mm3, viral load >200 copies/mL, history of malignancy, or pregnancy were excluded. 870 patients met criteria. The primary outcome was percent weight change over the follow up period (Δ = relative effects). The secondary outcome was the odds of ≥5kg weight gain over the study period. The effects of concurrent medications, medical comorbidities, ART combinations, and lifestyle behaviors on these outcomes were modeled using mixed effect regression analyses. Over a mean follow-up of 1.86 years, the study population gained a mean percent weight of 2.12 ± 0.21% (p<0.001) with an odds of ≥5kg weight gain of 0.293 (p<0.001). Men gained an average of 1.88 ± 0.22% over follow up, while women gained an average of 3.37 ± 0.51% over follow up (p=0.008 for the difference). Improvement in diet was associated with a decrease in weight change (Δ = -1.99 ± 0.47%, p= < 0.001) and a reduced odds of ≥5kg of weight gain (OR= 0.70, 95% CI = 0.50 - 0.97, p=0.03). In regression models, combination therapy with tenofovir alafenamide (TAF) and integrase strand transfer inhibitor (INSTI) containing regimens was associated with an increase in weight over the study period (Δ = 2.14 ± 0.45%, p< 0.001 and Δ = 1.09 ± 0.39%, p=0.005, respectively). Increasing age was significantly associated with a decrease in percent weight change over the study period (Δ = -0.68 ± 0.18% per year, p<0.001). Factors associated with weight gain include therapy with TAF and INSTI. Diet plays an influential role in attenuating weight gain in PWH.