Is treatment emergent weight gain on dolutegravir-based antiretroviral therapy reversible following discontinuation? A retrospective cohort study

Background: Weight gain following initiation of antiretroviral therapy (ART) is well described, particularly as part of “return‐to‐health”, however specific associations between weight gain and dolutegravir (DTG) have been reported.We evaluated weight changes following DTG therapy discontinuation amongst a cohort of adults living with HIV at one London centre. Method: Study design is a retrospective cohort study undertaken between November 2015 and December 2019. Eligible participants were on DTG ≥4 months and switched to a non‐DTG regimen with 6‐month minimum follow‐up post‐switch. We collected data on age, ethnicity, gender, CD4 count at time of DTG start, reason for discontinuation, NRTI backbone, weight/BMI prior to DTG start, at time of switch, and at 6 months post‐switch. Statistical analysis was descriptive, a comparison was made between those who gained significant weight and those who didn't using Fisher's exact test. Results: A total of 65 patients met our inclusion criteria, mean age was 45, mean CD4 count was 608 and mean time on DTG was 506 days. Data is available on weight for 46/65; of these 78% (36/46) gained weight during therapy. The average weight change on DTG was +2.54kg. Mean BMI increased from 25.70kg/m2 to 27.92kg/m2. 54% (25/46) gained significant weight (>2 kg). Of this group, 60% (15/25) were on ABC/3TC, 36% (9/25) were on TDF and 4% (1/25) were on F/TAF (Table P23.1)