Endo

Weight Gain in HIV

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Weight Gain in HIV, Obesity in HIV

  • See Also
  1. Endocrine Manifestations of HIV
  2. HIV Complications
  3. Insulin Resistance in HIV
  • Pathophysiology
  1. Effective ART increases weight by improving health and reversing HIV-related catabolism
  2. Specific Antiretroviral therapy (ART) agents may also increase weight
    1. Integrase Strand Transfer Inhibitors (Dolutegravir, Bictegravir)
    2. Nucleoside Reverse Transcriptase Inhibitor (nRTI, e.g. Tenofovir Alafenamide)
    3. Protease Inhibitors are associated with fat redistribution (Lipodystrophy)
  • Management
  1. See Obesity Management
  2. See Insulin Resistance in HIV
  3. See Hyperlipidemia Management in HIV
  4. Lifestyle changes (e.g. weight loss, Healthy Diet, Exercise)
  5. Consider GLP1 Agonists (e.g. Semaglutide, Tirzepatide)
  6. Avoid switching ART agents strictly for reasons of weight gain with a few exceptions
      1. Consider Protease Inhibitor change in Lipodystrophy
      2. Consider switching to Tenofovir disoproxil Fumarate (TDF) from Tenofovir Alafenamide (TAF)
  • References
  1. Chu (2017) Am Fam Physician 96(3): 161-9 [PubMed]
  2. Jaqua (2026) Am Fam Physician 113(1): 71-9 [PubMed]