Table 2.
Estimates of weight change by CYP2B6 metabolizer group, and difference in weight change between groups, among participants with viral suppression at time of switch, time points within 2 years after INSTI switch
| Variable | Unadjusted models | Adjusted modelsa | ||
|---|---|---|---|---|
| Estimate [95% CI] | P-value | Estimate [95% CI] | P-value | |
| All (n = 138) | ||||
| Weight change in normal metabolizers (kg/yr) | 2.23 [1.45 to 3.02]b | < 0.001 | 2.29 [1.51 to 3.07] | < 0.001 |
| Weight change in intermediate metabolizers (kg/yr) | 0.99 [0.15 to 1.83] | 0.02 | 0.93 [0.09 to 1.77] | 0.03 |
| Weight change in poor metabolizers (kg/yr) | 3.53 [2.06 to 5.01] | < 0.001 | 3.67 [2.21 to 5.14] | < 0.001 |
| Difference in weight change (Inter. vs. Normal) | −1.25 [−2.40 to −0.10] | 0.03 | −1.36 [−2.50 to −0.22] | 0.02 |
| Difference in weight change (Poor vs. Normal) | 1.30 [−0.37 to 2.97] | 0.1 | 1.39 [−0.27 to 3.04] | 0.1 |
| Male (n = 115) | ||||
| Weight change in normal metabolizers (kg/yr) | 2.55 [1.67 to 3.42] | < 0.001 | 2.64 [1.77 to 3.51] | < 0.001 |
| Weight change in intermediate metabolizers (kg/yr) | 0.57 [−0.40 to 1.54] | 0.3 | 0.53 [−0.43 to 1.49] | 0.3 |
| Weight change in poor metabolizers (kg/yr) | 3.73 [2.03 to 5.42] | < 0.001 | 3.66 [1.98 to 5.34] | < 0.001 |
| Difference in weight change (Inter. vs. Normal) | −1.98 [−3.29 to −0.68] | 0.003 | −2.10 [−3.40 to −0.81] | 0.002 |
| Difference in weight change (Poor vs. Normal) | 1.18 [−0.73 to 3.09] | 0.2 | 1.03 [−0.87 to 2.92] | 0.3 |
| Female (n = 23) | ||||
| Weight change in normal metabolizers (kg/yr) | 0.80 [−0.91 to 2.50] | 0.4 | 0.80 [−0.90 to 2.51] | 0.4 |
| Weight change in intermediate metabolizers (kg/yr) | 2.50 [0.89 to 4.10] | 0.003 | 2.32 [0.63 to 4.01] | 0.008 |
| Weight change in poor metabolizers (kg/yr) | 2.46 [−0.40 to 5.32] | 0.09 | 2.62 [−0.24 to 5.48] | 0.07 |
| Difference in weight change (Inter. vs. Normal) | 1.70 [−0.64 to 4.04] | 0.2 | 1.52 [−0.88 to 3.91] | 0.2 |
| Difference in weight change (Poor vs. Normal) | 1.66 [−1.66 to 4.99] | 0.3 | 1.82 [−1.51 to 5.15] | 0.3 |
| White (n = 74) | ||||
| Weight change in normal metabolizers (kg/yr) | 2.71 [1.60 to 3.82] | < 0.001 | 2.64 [1.53 to 3.75] | < 0.001 |
| Weight change in intermediate metabolizers (kg/yr) | 0.90 [−0.35 to 2.16] | 0.2 | 0.86 [−0.38 to 2.10] | 0.2 |
| Weight change in poor metabolizers (kg/yr) | 3.10 [0.46 to 5.74] | 0.02 | 3.42 [0.82 to 6.02] | 0.01 |
| Difference in weight change (Inter. vs. Normal) | −1.81 [−3.49 to −0.13] | 0.03 | −1.78 [−3.44 to −0.11] | 0.04 |
| Difference in weight change (Poor vs. Normal) | 0.38 [−2.48 to 3.25] | 0.8 | 0.78 [−2.05 to 3.61] | 0.6 |
| Black (n = 37) | ||||
| Weight change in normal metabolizers (kg/yr) | 1.21 [−0.50 to 2.92] | 0.2 | 1.30 [−0.42 to 3.02] | 0.1 |
| Weight change in intermediate metabolizers (kg/yr) | 0.61 [−1.12 to 2.34] | 0.5 | 0.85 [−0.95 to 2.64] | 0.4 |
| Weight change in poor metabolizers (kg/yr) | 2.81 [0.27 to 5.34] | 0.03 | 2.81 [0.26 to 5.36] | 0.03 |
| Difference in weight change (Inter. vs. Normal) | −0.59 [−3.03 to 1.84] | 0.6 | −0.46 [−2.96 to 2.05] | 0.7 |
| Difference in weight change (Poor vs. Normal) | 1.60 [−1.46 to 4.65] | 0.3 | 1.51 [−1.57 to 4.58] | 0.3 |
| Hispanic (n = 25) | ||||
| Weight change in normal metabolizers (kg/yr) | 2.16 [0.71 to 3.61] | 0.004 | 2.26 [0.76 to 3.76] | 0.004 |
| Weight change in intermediate metabolizers (kg/yr) | 1.74 [0.47 to 3.01] | 0.008 | 1.75 [0.47 to 3.03] | 0.008 |
| Weight change in poor metabolizers (kg/yr) | 5.61 [3.55 to 7.67] | < 0.001 | 5.63 [3.49 to 7.76] | < 0.001 |
| Difference in weight change (Inter. vs. Normal) | −0.42 [−2.35 to 1.51] | 0.7 | −0.51 [−2.47 to 1.45] | 0.6 |
| Difference in weight change (Poor vs. Normal) | 3.45 [0.93 to 5.97] | 0.008 | 3.37 [0.82 to 5.91] | 0.01 |
| Raltegravir (n = 26) | ||||
| Weight change in normal metabolizers (kg/yr) | 2.32 [0.67 to 3.97] | 0.006 | 2.52 [0.88 to 4.16] | 0.003 |
| Weight change in intermediate metabolizers (kg/yr) | −2.18 [−3.82 to −0.53] | 0.01 | −2.21 [−3.84 to −0.57] | 0.009 |
| Weight change in poor metabolizers (kg/yr) | 3.50 [0.04 to 6.97] | 0.05 | 3.53 [0.09 to 6.97] | 0.04 |
| Difference in weight change (Inter. vs. Normal) | −4.50 [−6.83 to −2.17] | < 0.001 | −4.73 [−7.04 to −2.41] | < 0.001 |
| Difference in weight change (Poor vs. Normal) | 1.18 [−2.66 to 5.02] | 0.5 | 1.01 [−2.80 to 4.82] | 0.6 |
| Elvitegravir (n = 38) | ||||
| Weight change in normal metabolizers (kg/yr) | 2.74 [1.86 to 3.63] | < 0.001 | 2.73 [1.83 to 3.63] | < 0.001 |
| Weight change in intermediate metabolizers (kg/yr) | 1.41 [0.35 to 2.46] | 0.009 | 1.40 [0.33 to 2.46] | 0.01 |
| Weight change in poor metabolizers (kg/yr) | 5.73 [4.20 to 7.25] | < 0.001 | 5.75 [4.19 to 7.31] | < 0.001 |
| Difference in weight change (Inter. vs. Normal) | −1.33 [−2.71 to 0.04] | 0.06 | −1.33 [−2.72 to 0.05] | 0.06 |
| Difference in weight change (Poor vs. Normal) | 2.98 [1.22 to 4.74] | 0.001 | 3.02 [1.24 to 4.80] | 0.001 |
| Dolutegravir (n = 67) | ||||
| Weight change in normal metabolizers (kg/yr) | 1.91 [0.70 to 3.12] | 0.002 | 1.93 [0.72 to 3.14] | 0.002 |
| Weight change in intermediate metabolizers (kg/yr) | 2.43 [1.14 to 3.73] | < 0.001 | 2.34 [1.05 to 3.63] | < 0.001 |
| Weight change in poor metabolizers (kg/yr) | 1.87 [−0.47 to 4.20] | 0.1 | 2.06 [−0.27 to 4.38] | 0.08 |
| Difference in weight change (Inter. vs. Normal) | 0.52 [−1.25 to 2.29] | 0.6 | 0.41 [−1.35 to 2.17] | 0.6 |
| Difference in weight change (Poor vs. Normal) | −0.05 [−2.67 to 2.58] | 0.9 | 0.12 [−2.50 to 2.75] | 0.9 |
| Pre-switch regimen included TDF (n = 89) | ||||
| Weight change in normal metabolizers (kg/yr) | 2.70 [1.52 to 3.88] | < 0.001 | 2.69 [1.50 to 3.87] | < 0.001 |
| Weight change in intermediate metabolizers (kg/yr) | 1.33 [0.04 to 2.61] | 0.04 | 1.37 [0.07 to 2.67] | 0.04 |
| Weight change in poor metabolizers (kg/yr) | 3.61 [1.58 to 5.64] | < 0.001 | 3.86 [1.84 to 5.89] | < 0.001 |
| Difference in weight change (Inter. vs. Normal) | −1.37 [−3.11 to 0.38] | 0.1 | −1.31 [−3.07 to 0.44] | 0.1 |
| Difference in weight change (Poor vs. Normal) | 0.92 [−1.43 to 3.26] | 0.4 | 1.18 [−1.17 to 3.52] | 0.3 |
a
Models were adjusted for race/ethnicity, CD4, age, BMI and INSTI type when they were not stratification factors.
b
Positive values for estimates indicate that participants gained weight post-switch. Positive values for estimates of difference on weight gain indicate that weight gain post-switch was greater than weight gain in CYP2B6 normal metabolizers.