Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV
Southern African Journal of HIV Medicine
| Field | Value | |
| Title | Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV | |
| Creator | Mondleki, Enkosi Banda, Clifford G. Chandiwana, Nomathemba C. Sokhela, Simiso Wiesner, Lubbe Venter, Francois Maartens, Gary Sinxadi, Phumla Z. | |
| Description | Background: Dolutegravir, a component of the preferred first-line antiretroviral therapy regimen, has been associated with increased weight gain. South Africa has a high prevalence of obesity, especially among women. Understanding dolutegravir exposure in patients with obesity is important for dose optimisation.Objectives: We compared the pharmacokinetic parameters of dolutegravir in Southern African adults living with HIV with and without obesity.Method: Blood samples were collected at various time points over a 24 h-period for dolutegravir assays. Non-compartmental analysis was conducted and geometric mean ratios (GMRs), with 90% confidence intervals (CIs), were generated to compare dolutegravir pharmacokinetic parameters between the groups. Regression analyses to assess predictors of dolutegravir exposure were done.Results: Forty participants were enrolled, 26 were women and 10 had obesity. Dolutegravir area under the concentration-time curve to 24-h and the maximum concentrations were not statistically significantly lower in participants with obesity: GMR 0.91 (90% CI: 0.71–1.16) and GMR 0.86 (90% CI: 0.68–1.07), respectively. In a multivariate linear regression analysis adjusting for age, gender, body mass index, creatinine clearance and randomisation arm (tenofovir alafenamide or tenofovir disoproxil fumarate), a unit increase in body mass index was associated with 1.2% lower dolutegravir area under the concentration-time curve to 24-h (P = 0.035).Conclusion: Dolutegravir exposure was marginally lower in participants with obesity, but this is not clinically significant. Our findings suggest that there is no need to dose adjust dolutegravir in people with obesity. | |
| Publisher | AOSIS | |
| Date | 2022-12-13 | |
| Identifier | 10.4102/sajhivmed.v23i1.1452 | |
| Source | Southern African Journal of HIV Medicine; Vol 23, No 1 (2022); 6 pages 2078-6751 1608-9693 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/1452/2983
https://sajhivmed.org.za/index.php/hivmed/article/view/1452/2984
https://sajhivmed.org.za/index.php/hivmed/article/view/1452/2985
https://sajhivmed.org.za/index.php/hivmed/article/view/1452/2986
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