Stavudine (D4-T, Zerit) and Didanosine (ddI, Videx). These changes in fat distribution put patients at risk for diabetes and the cosmetic impact affected their self-esteem. Fortunately, safer protease inhibitors like Atazanavir (Reyataz) and Darunavir (Prezista) became available as well as better nucleosides like Tenofovir (Viead) and Abacavir (Ziagen).
We do not fully understand why and how the integrase inhibitors are doing this. Increasing weight is generally not a good thing, except for patients who have experienced weight loss or wasting from advanced HIV infection. HIV patients are at higher risk of heart disease and diabetes, and many patients experience these conditions already, unrelated to HIV infection. Increasing weight can worsen this.
It also seems that all integrase inhibitors are not created equal in causing this problem. It was consistently shown that Dolutegravir was the worst culprit and Elvitegravir was the least, with Raltegravir somewhere in the middle. There was no data presented on Bictegravir.
If you have been taking any of the integrase inhibitors and have gained weight, be sure to talk to your medical provider. Your weight is recorded whenever you have a clinic visit so they should have some accurate numbers on how much weight you have actually gained. Develop a plan to increase physical activity and exercise and meet with a nutritionist to improve your diet. If all else fails, discuss changing your HIV medicines to ones that don’t cause this problem.
Teaching an Old Dog New Tricks
Metformin is an oral drug used to treat diabetes in patients who don’t require