Health
Certain HIV drugs can cause weight gain
Health Day Reporter
Tuesday, March 16, 2021 (HealthDay News)-Generally prescribed ingredients for therapeutically used life-saving antiretroviral cocktails HIV May trigger Weight gain, New research warns.
Concerns arise from tracking patients receiving antiretroviral therapy (Art). Since the mid-1990s, this treatment has relied on a combination of different drugs to essentially overturn HIV, control viral load, and bring once-fatal infections into control.
However, new research raises questions about one drug featured in many ART recipes. Tenofovir Alafenamide, also known as TAF.
There is no doubt that TAF will work. Researchers have stated that it is effective and well tolerated. In addition, TAF has become more popular in recent years due to its low risk. kidney Bone health than another drug called tenofovir disoproxil fumarate (TDF).
However, a new study found that patients on antiretroviral therapy with TAF increased by an average of about £ 4 over 18 months, compared to about £ 1.5 for patients taking drug cocktails containing TDF. understood.
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as a result, Normal weight Become a TAF user Overweight Or obesityThe findings show, compared to just over 8% of the TDF’s counterparts.
“TDF and TAF are common parts of these concomitant medications and most ART regimens,” said Dr. Michael Hoberg, director of HIV / division at Kaiser Permanente.AIDS And STD.. “That’s why this research is so important.”
Horberg, who was not involved in the study but reviewed the findings, noted that both drugs are also part of most so-called. PrEP Regimen. PrEP (pre-exposure prophylaxis)Designed to prevent HIV infection from becoming established in the first place, “more people [are] Maybe I’m using it for that, “he said.
Horberg said the new TAF drug is seen as the “answer” to the main problem with older TDF drugs that increased creatinine levels in some patients, an indicator of worsening renal function.
“And in most cases that’s true,” Hoberg said.
But weight gain and worsening lipid levels are also “not a minor issue,” he said, so new studies are important. Lipids are fatty substances that can accumulate and clog arteries.
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Most people don’t want to gain weight because of the drug, “and elevated lipids may be associated with cardiovascular disease (heart attack, stroke) and even HIV patients want to prevent it,” Hoberg said. It was.
In this study, a team led by Dr. Bernard Surial of the University of Bern Hospital in Switzerland reviewed weight gain data collected from more than 3,400 Swiss HIV patients between 2016 and 2019.
Everyone had been taking antiretroviral cocktails containing old TDF drugs for at least 6 months before switching to an ART regimen containing new TAF drugs.
The weight gain of the patients who switched was then accumulated for nearly 900 patients who adhered to TDF during the 18-month follow-up.
At that time, researchers found that not only was weight gain much more important among TAF users, but there was also an increase in cholesterol and triglyceride levels that could indicate an increased risk of heart damage. ..
Horberg said the findings were hardly surprising.
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“Our patients were aware of this weight gain before we were there,” he said. “And we used to say,’Oh, it’s not a medicine. You’re doing better, so you’re just eating more.'” Well, we now know that is not true. And if they didn’t have kidney problems, we might have been trying to fix problems that didn’t exist when switching treatments.
So what does this mean for future treatment options?
“Frankly, this has to be done on a case-by-case basis,” Hoberg said.
One of the considerations is money, as TDF is now a generic drug and is much cheaper than TAF.
“We want everyone to have access to these drugs, including PrEP,” Hoberg said. “But weight gain is a serious problem, and many patients don’t like how it feels or looks,” said PrEP takers.
If the weight gain is due to the drug, they will stop taking it, Hoberg said, so you have to balance it. If you have kidney concerns, it is important to switch. If not, he suggested that doctors should discuss the strengths and weaknesses of the change with the patient.
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Dr. Rajesh Gandhi, Fellow of the Infectious Diseases Society of America and President of the HIV Medical Association, also reviewed the findings.
“This difference in weight gain is because we’re paying attention to keeping people healthy for decades, not years,” Gandhi said.
Drugs that revolutionized HIV treatment in the mid-1990s effectively controlled the virus, but did not eliminate it. That is, he explained that when patients start taking ART drugs, they last a lifetime and are concerned about side effects.
“Today, there are far fewer side effects than when ART came out,” Gandhi said. “And the weight gain seen among people taking the new tenofovir formulation was relatively small, and not everyone was affected, but there was a difference.”
For patients with borderline kidney disease or osteoporosis, the new formulation has many benefits, Gandhi said, adding that further weight gain concerns need to be studied.
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In the meantime, the decision on which formulation to use should be based on discussions with each patient’s healthcare provider, “decided on a case-by-case basis,” he said.
The survey was published online on March 16th. Annual report of internal medicine..
For more information
Find out more about antiretroviral therapy at National Institutes of Health..
Source: Michael Horberg, MD, MAS, Director, HIV / AIDS and STDs, Kaiser Permanente and Care Management Institute, Rockville, MD; Rajesh Gandhi, MD, Chair and Fellow of the Infectious Diseases Society of America, and Chair of the HIV Medical Association. Annual report of internal medicine, March 16, 2021, online
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