Changes in waist circumference in HIV-infected individuals initiating a raltegravir or protease inhibitor regimen: Effects of sex and race

Priya Bhagwat, Ighovwerha Ofotokun, Grace A. McComsey, Todd T. Brown, Carlee Moser, Catherine A. Sugar, Judith S. Currier

Research output: Contribution to journalArticle

Abstract

Background. This study investigates the association of clinical and demographic predictors with abdominal fat gain, measured using waist circumference (WC) and self-reported abdominal size. Methods. We analyzed data from ACTG A5257, a clinical trial that randomized treatment-naïve HIV-infected participants to 1 of 3 antiretroviral regimens: raltegravir (RAL) or the protease inhibitors (PIs) atazanavir/ritonavir (ATV/r) or darunavir/ritonavir (DRV/r), each in combination with tenofovir disoproxil fumarate/emtricitabine. Associations of treatment and baseline/demographic characteristics with 96-week WC change were assessed using repeated-measures models. Ordinal logistic regression was used to examine the associations of predictors with week 96 self-reported abdominal changes. Results. The study population (n = 1809) was 76.0% male and predominantly black non-Hispanic (41.9%) and white non-Hispanic (34.1%). Mean baseline WC was 90.6 cm, with an average 96-week increase of 3.4 cm. WC increases were higher in the RAL arm compared with DRV/r (P = .0130). Females experienced greater increases in WC on RAL vs ATV/r than males (P = .0065). Similarly, a larger difference in WC change was found for RAL vs DRV/r for black vs nonblack individuals (P = .0043). A separate multivariable model found that in addition to the treatment regimen, higher baseline viral load and lower CD4+ were also associated with WC increases. Conclusions. With antiretroviral therapy initiation, higher WC increases in the RAL arm compared with PIs were more pronounced in female and black participants, and a more advanced baseline HIV disease state was a strong predictor of larger abdominal increases. Understanding factors predisposing individuals to abdominal fat gain could inform health management after therapy initiation.

Original languageEnglish (US)
JournalOpen Forum Infectious Diseases
Volume5
Issue number11
DOIs
StatePublished - Jan 1 2018

Keywords

  • Abdominal fat
  • Central adiposity
  • Lipodystrophy
  • Metabolic complications
  • Waist circumference

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

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