Association of weight gain with blood glucose trajectories in people living with HIV initiated on dolutegravir at Kisenyi health center IV, Kampala Uganda.

Abstract

Background: With the adoption of dolutegravir (DTG) in the first line antiretroviral therapy (ART) regimen as treatment of people living with HIV (PLWH), there has been observed weight gain and hyperglycemia among some patients. This has potentially contributed to the burden of non-communicable diseases (NCDs) globally and locally in Uganda. Since the World Health Organization (WHO) recommends NCDs care among PLWH, the study intends to show whether patients with weight gain translate into worse glucose outcomes and the need for continued monitoring. The study was carried out to determine the incidence of weight gain and its association with blood glucose trajectories in Ugandan PLWH initiated on DTG attending Kisenyi health center IV. Methods: This retrospective cohort study used data from 242 ART-naïve PLWH enrolled in the GLUMED study. Participants’ weight gain was categorized as minimal (0.1-9.9 kg) or maximum (≥ 10kg) over 48 weeks. Blood glucose levels were measured via a 2-hourly glucose tolerance test (2h-OGTT) at baseline, 12 and 36 weeks. The association between weight gain and glucose trajectories was analyzed using linear mixed-effects models. Results: Among participants, 74% gained weight, with 11.2% gaining ≥ 10kg. However, weight gain was not significantly associated with changes in blood glucose trajectories (p=0.434). No significant differences in glucose levels were observed between the minimal and maximum weight gain categories. Conclusion: The incidence proportion of weight gain was high in PLWH on DTG but there was no significant effect on the blood glucose trajectories. These findings suggest that routing glucose monitoring based on weight gain alone may not be necessary in this population. However, further long-term studies are needed to fully understand the metabolic effects of DTG in PLWH.