Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV. Mondleki, E., Banda, C. G, Chandiwana, N. C, Sokhela, S., Wiesner, L., Venter, F., Maartens, G., & Sinxadi, P. Z Southern African Journal of HIV Medicine, 23(1):a1452, dec, 2022.
Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV [link]Paper  doi  abstract   bibtex   
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.
@article{Mondleki2022,
abstract = {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.},
author = {Mondleki, Enkosi and Banda, Clifford G and Chandiwana, Nomathemba C and Sokhela, Simiso and Wiesner, Lubbe and Venter, Francois and Maartens, Gary and Sinxadi, Phumla Z},
doi = {10.4102/SAJHIVMED.V23I1.1452},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Mondleki et al. - 2022 - Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV.pdf:pdf},
issn = {2078-6751},
journal = {Southern African Journal of HIV Medicine},
keywords = {AIDS,Africa,African,HIV,OA,South Africa,after,age,analysis,antiretroviral,antiretroviral treatment optimisation,associated,based,care,data,disease,dolutegravir,drug,fund{\_}ack,group,guidelines,health,healthcare,individuals,infected,infection,model,months,obesity,original,patients,people,pharmacokinetics,population,positive,pregnancy,renal,risk,services,study,test,testing,therapy,time,treatment,virus,women,workers,years},
mendeley-tags = {OA,fund{\_}ack,original},
month = {dec},
number = {1},
pages = {a1452},
title = {{Effect of obesity on dolutegravir exposure in Black Southern African adults living with HIV}},
url = {https://sajhivmed.org.za/index.php/hivmed/article/view/1452/2983 https://sajhivmed.org.za/index.php/hivmed/article/view/1452/2984 https://sajhivmed.org.za/index.php/hivmed/article/view/1452/2985 https://sajhivmed.org.za/index.php/hivmed/article/view/1452},
volume = {23},
year = {2022}
}

Downloads: 0