Weight Gain in Incarcerated Individuals Living With HIV After Switching to Integrase Strand Inhibitor-Based Therapy

J Int Assoc Provid AIDS Care. 2021 Jan-Dec:20:2325958221996860. doi: 10.1177/2325958221996860.


Introduction: Post-marketing data have demonstrated the potential for weight gain with integrase inhibitors (INSTI) use in antiretroviral (ART) therapy.

Methods: A medical chart review evaluated virologically suppressed adult prisoners living with HIV and on a non-INSTI regimen before switching or adding an INSTI. Primary outcome assessed average weight change; Secondary outcomes evaluated change in body mass index (BMI), fasting lipid panel, and development of hypertension. Statistical analysis included paired t-tests and descriptive statistics.

Results: Among 103 study participants, 95% were men with a median age of 44 years. Each INSTI was associated with an average weight increase of 4.3 kg (p < 0.025). Bictegravir and dolutegravir were also associated with significant increases in BMI, +1.4kg/m2 and +2.8kg/m2, respectively (p = 0.011 and p = 0.001).

Conclusion: Patients receiving HIV care in a correctional setting and on INSTI-based treatments experienced weight gain and increases in BMI. Future research should focus on the mechanism of development and interventions to prevent weight gain.

Keywords: HIV/AIDS; antiretroviral therapy (ART); integrase strand transfer inhibitors (INSTI); weight gain.

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active*
  • Body Mass Index
  • Cohort Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Integrase Inhibitors / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Prisoners*
  • Retrospective Studies
  • Weight Gain / drug effects*


  • HIV Integrase Inhibitors