ESPE Abstracts

Medical antiretroviral treatment changed dramatically the course of the infection and life expectancy of people living with HIV (PLWH). However, age-dependent morbidity and mortality remains high, mostly due to non-HIV related conditions. Among others, cardiovascular diseases is nowadays an important cause of morbidity in PLWH. Integrase inhibitors are now part of the standard treatment scheme, because of their efficacy and tolerability. However, recent reports showed an important weight gain in adults treated with dolutegravir. The aim of the present study was the assessment of weight and body composition changes in a cohort of young PLWH, after switching to a dolutegravir-containing antiretroviral regimen. Vertically HIV infected young patients were enrolled at the time of switching (9 girls, 4 boys, aged 12-18 y). Body weight was evaluated by calculating the body mass index (BMI), and the triponderal mass index (TMI). Body composition was measured by dual energy X-ray absorptiometry (DXA) at the time of the switch to dolutegravir-containing regimen (T1) and after one year (T2). Quantification of abdominal adipose tissue was performed by means of a 1.5-T MRI system in a subset of 5 patients at T2. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SCAT) were measured. BMI values increased significantly (z=34,5, P=0,0134) between T1 (20.6±3.0 kg/m²) and T2 (21.5±3.2 kg/m²) while TMI did not change significantly over time (T1: 12.9±2.1; T2: 13.2±2.2 kg/m³). Body composition measurements showed a marked (z=31,0 P=0,0276) increase in trunk fat (T1: 20.2±9.1; T2: 23.1±10.4 %), together with a significant decrease (z=-36,0, P=0,0085) in the limbs/trunk fat ratio (T1: 1.3±0.3; T2: 1.1±0.3). The mean VAT area of our patients at MRI was significantly greater than the one of healthy subjects (t=5,4, P=0,0056). Conversely, mean SCAT areas were not significantly different (t=2,3, P=0,0822). Our results suggest a role of a dolutegravir-containing regimen in the increase of trunk fat at 12 months from the start of the new therapy. Additionally, the amount of VAT in our patients resulted significantly greater compared to healthy subjects, warranting the monitoring of these patients.