Why Is Weight Gain A Problem
If you were underweight when you started treatment, putting on a few pounds isn’t a bad thing. Getting to a healthy weight gives your body strength to fight HIV and other infections. Doctors used to call this weight gain a “return to health.”
But now the scales have tipped in the other direction. People with HIV in the United States are more likely to be overweight than those who dont have the virus. Putting on too many pounds can lead to health problems like diabetes and heart disease. If you have HIV, youre already at higher risk for these conditions.
Weight gain is an important thing to consider when you and your doctor choose an HIV drug, especially if you were overweight to start. You may be able to switch to a medicine that’s less likely to cause weight gain. Diet and exercise can help you stay at a healthy weight and avoid complications that are linked to being overweight.
Who Tends To Gain Weight With Hiv Treatment
There has been a signal from two studies that suggest the possibility of weight gain among people who have used the integrase inhibitor dolutegravir . However, those studies were done by looking back on data captured for another purpose. Such retrospective studies are useful for exploring an idea but firm conclusions cannot be drawn from them. That is why their results are only suggestive. Results from retrospective studies can be used to develop studies of a more robust statistical design.
To better explore the issue of weight gain among people using combination HIV therapy , researchers at clinics in Milan and elsewhere in Italy conducted a large observational study, assessing health-related data drawn from more than 1,000 HIV-positive people. Participants in this study used different regimens, anchored by integrase inhibitors, protease inhibitors or non-nukes. The researchers found that participants taking common combinations of HIV drugs had increases in weight and body mass index . People who were most likely to gain weight were those who were relatively thin or older prior to starting therapy.
Related:
Risk Factors For Weight Gain
Low CD4 count and injecting drug use were the factors associated with greatest weight gain over 96 weeks of follow-up, followed by black race and baseline viral load above 100,000 copies/ml.
People with CD4 counts below 200 gained more weight than people with higher CD4 counts and gains in weight closely tracked gains in CD4 count over time. A CD4 count below 200 was also the strongest risk factor for a weight gain of at least 10% of baseline weight .
People who injected drugs gained more weight than those who did not .
People with symptomatic HIV or AIDS at baseline gained 0.51kg more than people who were asymptomatic.
Race was associated with greater weight gain than gender. Longitudinal modelling showed that black women gained more weight than black men or white women over 96 weeks.
Recommended Reading: How Do You Know If You Got Hiv
Don’t Diet Simply Watch What You Eat
Like anyone with a weight problem, adjusting what and how much you eat is the first step to weight loss. An all-too-common problem is that we try fad diets and quick loss diets that may work in the short term but do nothing to keep the weight off. An effective diet is simply one that teaches you healthy eating habits that can serve you a lifetime.
Equally important is the need to identify exactly;why;you eat. Ultimately people eat for many reasons besides just hunger. It’s important to think about what triggers your eating outside of mealtimes. With the help of your food diary, you can start figuring out when and why you are eating in order to identify and control those impulses.
Can Dovato Be Used For Prep
No, the Food and Drug Administration hasnt approved Dovato to be used as PrEP. This stands for pre-exposure prophylaxis. PrEP is the use of a drug to prevent someone at high risk for HIV from contracting it. People considered to be high risk include those who share needles or have sex without a condom or other barrier method.
At this time, only two medications are FDA-approved as PrEP:
- emtricitabine/tenofovir disoproxil fumarate
- emtricitabine/tenofovir alafenamide
If you think PrEP might be helpful to you, talk with your doctor about which medication might be best.
You May Like: How Do Anti Hiv Drugs Work
Newer Type Of Hiv Drug Linked To Weight Gain
People on integrase inhibitors and protease inhibitors found to gain more weight on average than those on other treatment regimens
A study from the United States and Canada finds that people starting integrase inhibtor – and protease inhibitor -based antiretroviral treatment are more likely to experience weight gain than those on nonnucleoside reversetranscriptase inhibitor -based treatment.
Gaining weight after starting ART is common, particularly among people with lower CD4 cell counts and/or a lower body mass index . Weight gain as a result of HIV treatment used to be seen as a return to health. Yet in recent years, the average BMI of people starting ART has increased considerably,;in line with increased BMI in the general population. This;surfaces;concerns around the negative effect such weight gain;could have on peoples health.
The study set out to analyse changes in weight over time among people living with HIV, and examine whether different types of antiretroviral drugs are associated with greater weight gain. Due to having fewer side effects and drug resistance, newer INSTI-based drugs such as raltegravir, elvitegravir and dolutegravir are now the recommended treatment for most people living with HIV.
Around 22,900 adults, 87% of whom were men, who began ART through the North American AIDS Cohort Collaboration on Research and Design programme on or after January 2007 were followed until the end of 2016.
Rise In Lipid Levels With Taf
There are a number of studies showing that TDF-containing regimens oftentimes improve lipid levels by decreasing total cholesterol, LDL cholesterol and triglycerides, while TAF-containing regimens increase these levels. Higher levels of total cholesterol and LDL cholesterol can promote plaque buildup in arteries, which can lead to coronary artery disease, stroke and other health problems.
In the DISCOVER study, which compared Descovy to Truvada for PrEP, triglyceride and LDL cholesterol levels increased at 48 weeks for people taking Descovy compared to no change or a decrease in people taking Truvada. Decreases were seen in total cholesterol and HDL cholesterol .
Other studies have compared the lipid levels of people living with HIV taking TAF-containing or TDF-containing treatment regimens or switching from a TDF-containing regimen to a TAF-containing regimen.
Anobservational study conducted in Spain compared the lipid profiles of people on Genvoya or Stribild for HIV treatment over 48 weeks.;
Lipid levels increased from baseline among people taking Genvoya while remaining stable among people taking Stribild after 48 weeks of treatment. A higher percentage of people taking Stribild also had total cholesterol levels and LDL levels out of range after 48 weeks of treatment. Six people in the study discontinued Genvoya due to changes in lipid levels, and lipid levels returned to normal levels after returning to treatment that included TDF.
Also Check: Does Cookie Johnson Have Hiv
Just One Pill Once A Day
Once-daily SYMTUZA® is a complete prescription HIV treatment regimen in one pill. SYMTUZA® can be taken by adults and children who weigh at least 88 pounds who have never received HIV medicines in the past, or whose healthcare providers have determined that they meet certain requirements. It contains 800 mg darunavir/150 mg cobicistat/200 mg emtricitabine/10 mg tenofovir alafenamide fumarate. It is not known if SYMTUZA® is safe and effective in children under 18 years of age.
What Is Hiv Weight Loss
HIV weight loss, sometimes called HIV wasting syndrome, is an unplanned weight loss of more than 10 percent of body weight with either diarrhea or weakness and fever that lasts more than 30 days.
This type of weight loss often occurs with more advanced HIV. Lean body mass tends to be lost, but weight loss may be body fat as well.
While antiretroviral therapies have helped lower rates of this weight loss, estimates from 2016 suggested that between 14 and 38 percent of people with HIV will experience it.
The risk of death does increase with each 1 percent increase in weight loss from baseline weight in people living with HIV. Moreover, this risk rises by 11 percent with each 1 percent increase in weight loss from the prior visit.
HIV weight loss can result from a mix of factors such as:
You May Like: Can Hiv Ever Go Away
Can I Take Dovato If I Have Hiv And Hepatitis
It depends. In some cases, you may be able to take Dovato if you have both HIV and hepatitis. However, Dovato can cause your hepatitis infection to change or become drug-resistant.*
Your doctor may monitor your liver by giving you regular blood tests while youre taking Dovato. If your liver enzyme levels start to increase, it may be a sign that your liver isnt working as well as it should. In this case, your doctor may switch you to a different medication to treat your HIV.
If you have HIV and hepatitis, talk with your doctor. They can tell you if Dovato is a safe option for you.
boxed warning for hepatitis B virus thats resistant to certain drugs. Dovato also has a boxed warning for worsening of hepatitis B. A boxed warning is the strongest warning from the Food and Drug Administration . The warning alerts doctors and patients about drug effects that may be dangerous.
Darunavir Has A High Barrier To Drug Resistance
SYMTUZA® contains darunavir, which can help you keep fighting HIV with its high barrier to HIV drug resistance. Darunavir can help stop HIV from replicating. This is why treatments containing darunavir are recommended by the Department of Health and Human Services Guidelines when treatment is started immediately after an HIV diagnosis.
Also Check: How I Found Out I Had Hiv
How Is Biktary Used
Biktarvy, from Gilead, is an oral, 3-drug combination tablet used to treat immunodeficiency virus type 1 . It contains the integrase strand transfer inhibitor bictegravir 50 mg, along with 200 mg of emtricitabine and 25 mg of tenofovir alafenamide , both HIV-1 nucleoside analog reverse transcriptase inhibitors .
Biktarvy was FDA-approved in Feb. 2018 as a complete regimen for the treatment of HIV-1 infection in adults and children weighing at least 25 kg :
- who have no antiretroviral treatment history or,
- to replace the current antiretroviral regimen in those who are virologically-suppressed on a stable antiretroviral regimen with no history of treatment failure and no known substitutions associated with resistance to the individual components of Biktarvy.
Biktarvy is taken once a day, every day, with or without food.
Three integrase inhibitors are currently approved for use in the US for people living with HIV:
- raltegravir
Elvitegravir as a single agent was discontinued from the U.S. market in 2016.
Medication Can Cause Weight Gain
Appetite-stimulating meds
It is unfortunate that a great;number of;essential medications can stimulate the appetite and then lead to weight gain, which is often so great that previously slender individuals become obese.
Medications which have the potential to increase the appetite and weight, include:;;;;;;;;;;;;
- Psychotropics
- Typical and atypical antipsychotics
- Tricyclic antidepressants , MAOI antidepressants , and other antidepressants
- Anticonvulsants
- Hormones including human growth hormone, corticosteroids, and human reproductive hormones
Contributing factors
A number of other factors can also contribute to the pronounced weight gain that some patients experience when they use the above mentioned drugs.
Eating disturbances related to anxiety
While anti-anxiety drugs in the psychotropic category can cause weight gain, it should be kept in mind that many people turn to food when they are stressed or anxious.; “Comfort food” can help ease the pain of anxiety, but these typical consolation foods are often very high in energy, fat and sugar , and will pile on the kilos. Patients seeking relief from their anxiety do not usually nibble on celery or fat-free cottage cheese! These patients seek relief in foods dripping with fat and loaded with kJ and sugar.
Eating disturbances related to depression
Eating disturbances related to anticonvulsants
Eating disturbances related to hormones
Lipodystrophy associated with HAART therapy
|
Listed in MIMS |
|
Medroxyprogesterone acetate Testosterone |
Recommended Reading: Does Hiv Cause Hair Loss
Higher Weight Gain With Taf
When used by people who are HIV-negative for PrEP, Descovy may cause a small amount of weight gainor at least may not prevent normal weight gain as happens with Truvada. This is the case for cisgender men and possibly trans women .
On average, cis men and trans women who participated in the DISCOVER study of Descovy for PrEP gained 1 kg after taking medication for 48 weeks. People taking Truvada lost a small amount of weight at weeks 12 and 24, and then returned to baseline weight at weeks 36 and 48.
In themetabolic sub-study of the iPrEx study, cis men and trans women taking Truvada for PrEP experienced weight loss after 24 weeks, with weight increases at later visits similar to that of placebo. The average total weight loss among people taking Truvada compared to people taking placebo was -0.8% at week 24. By week 96, the median weight of people taking Truvada was not significantly different from placebo.
Modest weight gain is expected in people during adulthood. Because people taking Truvada decreased their weight by -0.1% at week 24 in the iPrEx study, and showed less weight gain than people taking placebo at weeks 48 and 72, Truvada may initially prevent normal weight gain but, according to this study, this effect may fade with long-term use.
Mean change in weight to Week 96: men
Does Dovato Cause Weight Gain
In clinical trials, people taking Dovato didnt report weight gain as a side effect of the medication. However, in postmarketing studies, weight gain was reported as a side effect. Postmarketing studies are done after a drug has already been approved by the Food and Drug Administration . Its not known how many people may have experienced weight gain with Dovato.
However, other clinical trials have shown that dolutegravir may increase weight.
Its also possible that as your HIV is treated, you may gain weight as your body becomes stronger.
If you experience unexpected weight gain while taking Dovato, talk with your doctor. They can help determine the cause and what a healthy weight is for you.
Recommended Reading: What Is The Hiv Rate In Atlanta
Does Tenofovir Alafenamide Cause Weight Gain
Stribild contains elvitegravir, emtricitabine, and the original form of tenofovir known as tenofovir disoproxil fumarate . When TDF was compared with the newer tenofovir alafenamide , more weight gain was seen with TAF than with TDF at 96 weeks.
Elvitegravir / cobicistat was also associated with a significantly higher odds of more than a 10% weight gain when compared to efavirenz.
However, investigators did not find a link between >10% weight gain and metabolic effects such as increased blood sugar or type 2 diabetes. In addition, obesity at study entry was not found to be a risk factor for weight gain in the meta-analysis.
Is It Ever Ok To Lose Weight When Living With Hiv
Wider introduction and use of ART has been linked to increased weight gain and cases of overweight and obesity in people living with HIV.
Those with overweight and obesity may have a higher body mass index and a higher ratio of BMI to visceral fat, a type of body fat stored in the abdominal cavity. It wraps around vital organs such as the pancreas and liver.
Compared to the general population, having this ratio combined with HIV may raise the risk for health issues such as heart disease, type 2 diabetes, and certain cancers.
For instance, data from 2016 found that for every 5 pounds someone with HIV gains, the risk for diabetes goes up by 14 percent, compared to 8 percent in the general population.
For those with overweight or obesity and HIV, losing weight may improve overall health and lessen the risk of some health issues.
Read Also: What Does The Hiv Virus Look Like
Why Do Some Newer Hiv Drugs Cause Weight Gain
Future research should examine how particular combinations of antiretrovirals contribute to weight gain, according to one expert.
Some of the newer antiretrovirals , in particular integrase inhibitors, have been associated with weight gain, aidsmap reports. Given this concerning finding, researchers should set their sights on understanding which particular combinations of ARVs are the biggest drivers of weight gain among people with HIV.
That is according to an address given by Andrew Hill, PhD, of the University of Liverpool at the 17th European AIDS Conference in Basel, Switzerland, this month.
To some degree, the weight gain seen after individuals start ARVs is a result of the return to health effect among individuals who started with a compromised immune system. However, it is clear that this is not the only factor, given how weight gain can differ based on which ARVs individuals take.
The integrase inhibitors dolutegravir and bictegravir are associated with the greatest weight gains. Dolutegravir is sold as a stand-alone pill under the brand name Tivicay and is included in Juluca, Dovato and Triumeq. Bictegravir is included in Biktarvy and is not approved as a stand-alone tablet.
Research has consistently indicated that TDF-containing regimens are associated with less weight gain compared with regimens containing Ziagen or the newer version of TDF, tenofovir alafenamide . Abacavir is included in Triumeq, Epzicom and Trizivir.
To read the aidsmap article, .
Why Do Hiv Drugs Cause Weight Gain
Weight gain is a common side effect of antiretroviral therapy . On average, people put on about 4 pounds during the first 2 years of their treatment. Most of that gain happens in the first year.
About 1 in 5 people who were at a healthy weight when they were diagnosed with HIV become overweight within 3 years after going on these drugs.
Scientists aren’t sure why HIV medications cause weight gain. One possible reason is that they work. When you have HIV, your body constantly burns calories fighting infections. ART stops you from getting infections.
HIV treatment also helps you keep your appetite. And it helps your body absorb more of the nutrients from the foods you eat.
Your lifestyle also affects your weight. A high-calorie, high-fat diet and too little exercise could cause you to gain more weight while you’re on treatment.
You May Like: How Much To Get Hiv Test