People living with HIV and Aids (PLHIV) who take antiretroviral therapy (ART) may gain more weight and have higher blood pressure than those on other regimens, a study has found.
The study, conducted at Newlands Clinic in Harare, compared the health outcomes of 9,487 adults who started or switched to three different ART regimens between January 2004 and June 2022: dolutegravir (DTG)-based, efavirenz (EFV)-based, and ritonavir-boosted atazanavir (ATV/r)-based therapies.
The researchers, led by Tinei Shamu, Matthias Egger, Tinashe Mudzviti, Cleophas Chimbetete, Justen Manasa, and Nanina Anderegg, found that those on DTG-based ART gained more weight and had higher blood pressure than those on the other two regimens over a 24-month period.
Women on DTG-based ART gained an average of 4.54 kg and men gained 3.71 kg, while those on ATV/r and EFV-based therapies gained less. The proportion of people with high blood pressure on DTG-based ART rose from about 5% to over 20%, while it remained stable in the other groups.
The study also found a link between weight gain and blood pressure among those on DTG-based ART, with larger weight gains associated with higher blood pressure levels. However, even those who did not gain much weight had an increased risk of high blood pressure after switching to DTG-based ART.
The reasons for these differences are not clear, but the study suggests that monitoring weight and blood pressure in PLHIV, especially those on DTG-based ART, is important. Interventions to lower blood pressure could help prevent cardiovascular complications related to certain ART regimens.
The study has some limitations, such as possible confounding factors and incomplete blood pressure data in some groups. More research is needed to understand the mechanisms behind these weight and blood pressure changes and to find ways to reduce health risks in PLHIV.
Tinei Shamu, Laboratory Manager at Newlands Clinic and one of the study authors, said health facilities should check these parameters and take note of the changes in weight and hypertension when patients come for refills.
He said this was not only for research but for the safety of patients.
“The take home message is for the healthcare facilities. They should check those parameters and take note of the changes in weight and hypertension when patients come for refills. Not only for research but for the safety of patients so they do not miss patients who are gaining excess weight and elevated blood pressure,” Dr Shamu said.
