Alteração no índice de massa corpórea: um estudo de coorte em indivíduos em uso de dolutegravir atendidos em um serviço especializado de Belo Horizonte.

Abstract

Objective: To evaluate changes in BMI variation among PLHIV after the beginning or modification of ART to a therapeutic regimen with DTG. Methods: Retrospective and prospective cohort of individuals registered in a reference service unit in the treatment of PLHIV in Belo Horizonte, who started or started to use DTG by means of an exchange in ART from February/2017 to March/2020. Secondary data from the clinical records, from the Medicines Logistics System and from the Laboratory Examination Control System were used regarding weight, TCD4+ cell count, viral load, date of birth, and sociodemographic characteristics. The analysis of BMI variation in the established periods at weekly intervals of 1-24(t1), 25-48(t2), 49-72(t3) and 73-96(t4) were performed using the Wilcoxon test and the generalized estimation equations model (GEE), with a 5% significance level. Results: In the 614 individuals, the mean age was 38.4 years, most men (85.8%) and 52.3% using DTG. Individuals who started ART with DTG or who were immunosuppressed showed a significantly higher BMI increase than those who switched to DTG or who were not immunosuppressed (p-value<0.05). On average, the variation in BMI in the group that started ART with DTG was 1.02 kg/m2 in 96 weeks and 0.56 kg/m2 in the group that changed to DTG (p-value<0.05). The changes in BMI were associated with the time of use of DTG, the type of ART, the immune status, nutritional and age (p-value<0.05). Conclusions: The results suggest that the use of DTG is related to weight gain in both groups, however, for individuals on early ART use of DTG, the weight gain was significantly higher, which may lead with more ease to the development of comorbidities such as obesity.