A review of dolutegravir-associated weight gain and secondary metabolic comorbidities

被引:2
|
作者
Jemal, Mohammed [1 ]
机构
[1] Debre Markos Univ, Sch Med, Dept Biomed Sci, POB 269, Debre Markos, Amhara, Ethiopia
来源
SAGE OPEN MEDICINE | 2024年 / 12卷
关键词
Dolutegravir; integrase inhibitors; weight gain; HIV; metabolic comorbidities; TENOFOVIR DISOPROXIL FUMARATE; ANTIRETROVIRAL-NAIVE ADULTS; ONCE-DAILY DOLUTEGRAVIR; SEXUAL-DIMORPHISM; HIV-INFECTION; EFAVIRENZ; THERAPY; OBESITY; LEPTIN; PHARMACOGENETICS;
D O I
10.1177/20503121241260613
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Dolutegravir is an integrase inhibitor and is recommended by the World Health Organization as the preferred first-line and second-line human immunodeficiency virus treatment in all populations. Excessive weight gain associated with dolutegravir-based regimens is an emerging issue; however, the long-term metabolic consequences of this effect have not been fully understood. Growing evidence shows that this leads to a higher incidence of hyperglycemia, hypertension, and metabolic syndrome, along with elevated cardiovascular risk. Dolutegravir-based regimens, also associated with greater adipocyte differentiation and greater expression of markers associated with lipid storage, continue to be a problem among patients living with human immunodeficiency virus. The mechanisms by which certain antiretroviral therapy agents differentially contribute to weight gain remain unknown. Some clinical investigators speculate that dolutegravir could interfere with central nervous system appetite regulation (melanocortin-4 receptor) and insulin signaling, or may have better penetration of adipose tissue where they could exert a direct impact on adipose tissue adipogenesis, fibrosis, and insulin resistance. This review summarizes our current understanding of weight gain and fat changes associated with dolutegravir and its possible secondary metabolic comorbidities.
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页数:9
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