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

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.