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Changes in body mass index in children and adolescents living with HIV in Europe and Thailand starting dolutegravir

Edgar, Kate; The Epidemiology of Pregnancy and Paediatric, Infections International Cohort Collaboration (EPPICC) study gr; (2025) Changes in body mass index in children and adolescents living with HIV in Europe and Thailand starting dolutegravir. Open Forum Infectious Diseases , Article ofaf640. 10.1093/ofid/ofaf640. (In press). Green open access

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Abstract

Background: Excess weight gain has been reported in some adults on dolutegravir (DTG), but data in children/adolescents living with HIV (CALHIV) are limited. // Methods: CALHIV aged 2-<18 years (yrs) at DTG start from 15 observational cohorts across Europe and Thailand were included. Mixed-models described changes in body mass index-for-age z-score(zBMI). We assessed (i) zBMI change 48 weeks(wks) before versus after DTG start; (ii) zBMI change up to 96wks on DTG and associated factors; and (iii) zBMI changes over 96wks in CALHIV aged 6-<18yrs at start of DTG versus protease inhibitor(PI)-based regimens using propensity score weighting. // Results: Of 948 CALHIV on DTG, 50% were female, median[IQR] age 13.7[11.1,15.6] years, zBMI 0.31[-0.64,1.19], 48% Black, 30% overweight or obese at DTG start. Among 741 with zBMI available pre/post DTG start, zBMI (95% CI) increased by 0.07(0.03,0.11) versus 0.13(0.09,0.16) (p=0.087), in the 48wks before and after DTG start, respectively. Mean zBMI change by 96wks on DTG was 0.20(0.14,0.27). In multivariable models, greatest increases in zBMI were in those aged 6-<12yrs at DTG start (0.34(0.23,0.44)), males of ‘Other’ ethnicity(0.39(0.10,0.68)), Black females(0.27(0.15,0.39)), and those on tenofovir alafenamide(TAF) (0.39(0.17,0.61)). There was no difference in mean zBMI change at 96wks among those on DTG versus PI-based regimens (0.21(0.13,0.30) vs 0.30(0.13,0.48), p=0.354). // Conclusions: CALHIV experienced zBMI increases on DTG with largest gains in children aged 6-<12yrs, on TAF, with low baseline zBMI, and some variation by sex and ethnicity. However, zBMI changes over 96 weeks were comparable between those on DTG and PI-based regimens.

Type: Article
Title: Changes in body mass index in children and adolescents living with HIV in Europe and Thailand starting dolutegravir
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/ofid/ofaf640
Publisher version: https://doi.org/10.1093/ofid/ofaf640
Language: English
Additional information: Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10218107
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