Annals of epidemiology · 2026
Initiation of dolutegravir vs efavirenz on 12- and 24-month weight, body mass index, blood pressure, and incident hypertension: A target trial emulation.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zheng Amy, Fox Matthew P, Greener Ross, Kileel Emma M, Bor Jacob, Venter Willem Df, Pisa Pedro T, Murray Eleanor J, Brennan Alana T, Maskew Mhairi
Аннотация
OBJECTIVE: Using the Target Trial Emulation Framework, we evaluated the impact of initiating dolutegravir versus efavirenz on 12- and 24-month weight, body mass index (BMI), blood pressure (BP), and incident hypertension among treatment-naïve individuals in Johannesburg, South Africa from 2019 to 2022.
METHODS: We used linear models to estimate the mean difference in weight, BMI, BP and a log-binomial model to estimate the causal risk difference of incident hypertension, adjusting for patient characteristics via inverse probability weighting.
RESULTS: Among 2930 people initiating treatment from 2019 to 2022, 1847 initiated dolutegravir and 1083 initiated efavirenz. At 12-months, mean difference comparing dolutegravir to efavirenz in weight was 2.9 kg (95% Confidence Interval (CI): -0.3, 5.5), BMI was 0.8 kg/m2 (95% CI: -0.3, 1.9), diastolic BP was 1.6 mmHg (95% CI: -0.7, 3.9) and systolic BP was 3.9 mmHg (95% CI: 1.2, 6.6). Risk of incident hypertension rose by 35% (95% CI: 0.04, 0.5). At 24-months, mean weight difference was 1.9 kg (95% CI: -1.3, 5.1), BMI was 0.6 kg/m2 (95% CI: -0.6, 1.9), diastolic BP was -0.4 mmHg (95% CI: -1.8, 5.1) and systolic BP was 1.7 mmHg (95% CI: -1.8, 5.1). Risk of incident hypertension rose by 22% (95% CI: -0.1, 0.4).
CONCLUSIONS: Dolutegravir was associated with greater increases in weight, systolic BP, and incident hypertension over 24-months, particularly in the first 12-months. Future research is needed to determine whether this reflects a direct effect of dolutegravir or the weight-suppressing effects of efavirenz.
METHODS: We used linear models to estimate the mean difference in weight, BMI, BP and a log-binomial model to estimate the causal risk difference of incident hypertension, adjusting for patient characteristics via inverse probability weighting.
RESULTS: Among 2930 people initiating treatment from 2019 to 2022, 1847 initiated dolutegravir and 1083 initiated efavirenz. At 12-months, mean difference comparing dolutegravir to efavirenz in weight was 2.9 kg (95% Confidence Interval (CI): -0.3, 5.5), BMI was 0.8 kg/m2 (95% CI: -0.3, 1.9), diastolic BP was 1.6 mmHg (95% CI: -0.7, 3.9) and systolic BP was 3.9 mmHg (95% CI: 1.2, 6.6). Risk of incident hypertension rose by 35% (95% CI: 0.04, 0.5). At 24-months, mean weight difference was 1.9 kg (95% CI: -1.3, 5.1), BMI was 0.6 kg/m2 (95% CI: -0.6, 1.9), diastolic BP was -0.4 mmHg (95% CI: -1.8, 5.1) and systolic BP was 1.7 mmHg (95% CI: -1.8, 5.1). Risk of incident hypertension rose by 22% (95% CI: -0.1, 0.4).
CONCLUSIONS: Dolutegravir was associated with greater increases in weight, systolic BP, and incident hypertension over 24-months, particularly in the first 12-months. Future research is needed to determine whether this reflects a direct effect of dolutegravir or the weight-suppressing effects of efavirenz.