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Impact of body weight on virological and immunological responses to efavirenz-containing regimens in HIV-infected, treatment-naive adults.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Marzolini Catia, Sabin Caroline, Raffi François, Siccardi Marco, Mussini Cristina, Launay Odile, Burger David, Roca Bernardino, Fehr Jan, Bonora Stefano, Mocroft Amanda, Obel Niels, Dauchy Frederic-Antoine, Zangerle Robert, Gogos Charalambos, Gianotti Nicola, Ammassari Adriana, Torti Carlo, Ghosn Jade, Chêne Genevieve, Grarup Jesper, Battegay Manuel,
Project Swiss HIV Cohort Study (SHCS)
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Original article (peer-reviewed)

Journal AIDS (London, England)
Page(s) 193 - 200
Title of proceedings AIDS (London, England)
DOI 10.1097/qad.0000000000000530

Open Access

URL https://www.zora.uzh.ch/id/eprint/105800/
Type of Open Access Repository (Green Open Access)

Abstract

The prevalence of overweight and obesity is increasing among HIV-infected patients. Whether standard antiretroviral drug dosage is adequate in heavy individuals remains unresolved. We assessed the virological and immunological responses to initial efavirenz (EFV)-containing regimens in heavy compared to normal-weight HIV-infected patients. Observational European cohort collaboration study. Eligible patients were antiretroviral-naïve with documented weight prior to EFV start and follow-up viral loads after treatment initiation. Cox regression analyses evaluated the association between weight and time to first undetectable viral load (<50 copies/ml) after treatment initiation, and time to viral load rebound (two consecutive viral load >50 copies/ml) after initial suppression over 5 years of follow-up. Recovery of CD4 cell count was evaluated 6 and 12 months after EFV initiation. Analyses were stratified by weight (kg) group (I - <55; II - >55, <80 (reference); III - >80, <85; IV - >85, <90; V - >90, <95; VI - >95). The study included 19,968 patients, of whom 9.1, 68.3, 9.1, 5.8, 3.5, and 4.3% were in weight groups I-VI, respectively. Overall, 81.1% patients attained virological suppression, of whom 34.1% subsequently experienced viral load rebound. After multiple adjustments, no statistical difference was observed in time to undetectable viral load and virological rebound for heavier individuals compared to their normal-weight counterparts. Although heaviest individuals had significantly higher CD4 cell count at baseline, CD4 cell recovery at 6 and 12 months after EFV initiation was comparable to normal-weight individuals. Virological and immunological responses to initial EFV-containing regimens were not impaired in heavy individuals, suggesting that the standard 600 mg EFV dosage is appropriate across a wide weight range.
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