Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV
| Title: | Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV |
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| Authors: | Enkosi Mondleki, Clifford G. Banda, Nomathemba C. Chandiwana, Simiso Sokhela, Lubbe Wiesner, Francois Venter, Gary Maartens, Phumla Z. Sinxadi |
| Source: | Southern African Journal of HIV Medicine, Vol 23, Iss 1, Pp e1-e6 (2022) |
| Publisher Information: | AOSIS, 2022. |
| Publication Year: | 2022 |
| Collection: | LCC:Public aspects of medicine LCC:Infectious and parasitic diseases |
| Subject Terms: | pharmacokinetics, dolutegravir, obesity, south africa, antiretroviral treatment optimisation, hiv, Public aspects of medicine, RA1-1270, Infectious and parasitic diseases, RC109-216 |
| More Details: | 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. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1608-9693 2078-6751 |
| Relation: | https://sajhivmed.org.za/index.php/hivmed/article/view/1452; https://doaj.org/toc/1608-9693; https://doaj.org/toc/2078-6751 |
| DOI: | 10.4102/sajhivmed.v23i1.1452 |
| Access URL: | https://doaj.org/article/a6629d34d35249ea887fd4b45fa2b85c |
| Accession Number: | edsdoj.6629d34d35249ea887fd4b45fa2b85c |
| Database: | Directory of Open Access Journals |
| ISSN: | 16089693 20786751 |
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| DOI: | 10.4102/sajhivmed.v23i1.1452 |
| Published in: | Southern African Journal of HIV Medicine |
| Language: | English |