Antiretroviral Agents and Weight Change in People Living with HIV at Sultan Qaboos University Hospital Oman. An Observational Single-Center Study

Objectives: Weight gain in patients living with human immunodeficiency virus infection has been linked to a number of antiretroviral medications including tenofovir alafenamide and integrase strand transfer inhibitors. We studied our cohort of patients with regard to weight changes after introduction of tenofovir alafenamide either on its own or in combo drugs such as Taffic. Methods: this is an observational retro- and prospective study covering the period from 8th Feb 2020 until 20th March 2025 under Ethical approval: MREC: #3230. Relevant data were extracted from the hospital electronic records. Excel was used to do statistical analysis for descriptive analysis, chi-square for independence and Mann-Whitney tests. Results: 46.4% of patients had genuine weight gain 1 year post initiation of tenofovir alafenamide-containing agents with a median age 41 (21 - 69) and M:F of 41:29. Median age gain was 4.45 kg. Weight was stable or lost in 41%, and the remaining 12.6% had weight gain before the initiation of the agent. Age (above or below 50 years) had no impact on determining weight gain (X2: (1, N = 132) = 2.6, p: 0.106), however, it had a significant impact on the amount of weight gained (6.1 vs 4 kg in patients ≤50 and >50 years of age respectively (6.1 vs 4 kg, U: 335, n1 = 86, n2 = 46, z score: 2.14, p: 0.032, with a small size effect r = 0.186). Gender had no impact on determining weight gain (X2: (1, N: 132) = 1.66, p 0.198) nor in the magnitude of gained weight (6 vs 4.7 kg in males and females respectively (U = 565, n1: 84, n2: 48 z score = 0.27, p = 0.79, r: 0.0234). Diabetes mellitus was lower in the group that gained weight (27.4% vs 12.9%, X2 (1, N: 132) = 4.46, p = 0.035). Conclusion: genuine weight gain was observed in our population in patients on a combination of TAF and bictegravir. Diabetes mellitus was higher in the group that did not gain weight in contrast to other studies. This could reflect ethnic differences or the effect of diabetes on the metabolic effects of the weight-increasing antiretroviral agents.