Antiretroviral Therapy-Associated Weight Gain in Mexico, a Country Prone to Comorbidities

Document Type : Viewpoint

Authors

1 Plan de Estudios Combinados en Medicina (PECEM), Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico

2 Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

Keywords


 

Introduction

 

Advancements in antiretroviral therapy (ART) have drastically improved the quality of life for people with human immunodeficiency virus (PWH). Modern ART is more efficient at achieving both virological suppression and immunological reconstitution and at decreasing the emergence of resistance to treatment.1 ...(Read more...)

  1. Sokhela S, Lalla-Edward S, Siedner MJ, Majam M, Venter WD. Roadmap for achieving universal antiretroviral treatment. Annu Rev Pharmacol Toxicol. 2023;63:99-117. doi:1146/annurev-pharmtox-052020-094321
  2. Guzman N, Vijayan V. HIV-associated lipodystrophy. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK493183/.
  3. Pau AK, George JM. Antiretroviral therapy: current drugs. Infect Dis Clin North Am. 2014;28(3):371-402. doi:1016/j.idc.2014.06.001
  4. Wood BR, Huhn GD. Excess weight gain with integrase inhibitors and tenofovir alafenamide: what is the mechanism and does it matter? Open Forum Infect Dis. 2021;8(12):ofab542. doi:1093/ofid/ofab542
  5. Bourgi K, Jenkins CA, Rebeiro PF, et al. Weight gain among treatment-naïve persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada. J Int AIDS Soc. 2020;23(4):e25484. doi:1002/jia2.25484
  6. Venter WD, Moorhouse M, Sokhela S, et al. Dolutegravir plus two different prodrugs of tenofovir to treat HIV. N Engl J Med. 2019;381(9):803-815. doi:1056/NEJMoa1902824
  7. Kumar S, Samaras K. The impact of weight gain during HIV treatment on risk of pre-diabetes, diabetes mellitus, cardiovascular disease, and mortality. Front Endocrinol (Lausanne). 2018;9:705. doi:3389/fendo.2018.00705
  8. Venter WD, Serenata C, Vitoria M, et al. What we have learned from antiretroviral treatment optimization efforts over the last 5 years? AIDS. 2021;35(Suppl 2):S113-S115. doi:1097/qad.0000000000003081
  9. MacCann R, Landay AL, Mallon PW. HIV and comorbidities - the importance of gut inflammation and the kynurenine pathway. Curr Opin HIV AIDS. 2023;18(2):102-110. doi:1097/coh.0000000000000782
  10. Lugo G. Obesidad, Epidemia Agudizada en México. Gaceta UNAM; 2021. https://www.gaceta.unam.mx/obesidad-epidemia-agudizada-en-mexico/.
  11. Instituto Mexicano del Seguro Social (IMSS). IMSS Realizó Casi 3.5 Millones de Atenciones de Pacientes Que Viven Con Diabetes Durante. IMSS; 2023. https://imss.gob.mx/prensa/archivo/202311/569#:~:text=Inform%C3%B3%20que%20la%20Encuesta%20Nacional. Accessed May 2, 2024.
  12. Campos-Nonato I, Oviedo-Solís C, Vargas-Meza J, et al. Prevalencia, tratamiento y control de la hipertensión arterial en adultos mexicanos: resultados de la Ensanut 2022. Salud Publica Mex. 2023;65:s169-s180. doi:21149/14779
  13. Aguilar-Salinas CA. Epidemiología de Las Enfermedades Metabólicas Resultantes de La Malnutrición: El Caso de México. Alimentación y Salud. https://alimentacionysalud.unam.mx/epidemiologia-enfermedades-metabolicas/.
  14. Instituto Nacional de Estadística y Geografía (INEGI). Estadísticas de Defunciones Registradas (EDR). 2023. https://www.inegi.org.mx/app/saladeprensa/noticia.html?id=8911#:~:text=Entre%20enero%20y%20septiembre%20de. Accessed May 2, 2024.
  15. World Bank. Data for Upper Middle Income, Mexico. 2019. https://data.worldbank.org/?locations=MX-XT.
  16. Consejo Nacional de Evaluación de la Política de Desarrollo Social (CONEVAL). Medición de Pobreza. 2022. https://www.coneval.org.mx/Medicion/MP/Paginas/Pobreza_2022.aspx.
  17. Bertagnolio S, Hermans L, Jordan MR, et al. Clinical impact of pretreatment human immunodeficiency virus drug resistance in people initiating nonnucleoside reverse transcriptase inhibitor-containing antiretroviral therapy: a systematic review and meta-analysis. J Infect Dis. 2021;224(3):377-388. doi:1093/infdis/jiaa683
  18. García-Morales C, Ávila-Ríos S. Prevalencia de Resistencia Adquirida a Fármacos Antirretrovirales en El Centro de México. 2020. https://www.gob.mx/cms/uploads/attachment/file/626488/Bolet_n_de_Atenci_n_Integral_de_Personas_con_VIH__Censida.pdf.
  19. Short WR, Ramgopal M, Hagins DP, et al. 1985. A prospective, randomized trial to assess a protease inhibitor–based regimen switch strategy to manage integrase inhibitor–related weight gain. Open Forum Infect Dis. 2023;10(Suppl 2):ofad500.112. doi:1093/ofid/ofad500.112
  20. McComsey GA, Molina JM, Mills AM, et al. Weight and body composition after switch to doravirine/islatravir (DOR/ISL) 100/0.75mg once daily: week 48 results from 2 randomized active-controlled phase 3 trials, MK8591A-017 (P017) and MK8591A-018 (P018). https://www.natap.org/2023/IAS/IAS_51.htm. Accessed May 2, 2024.
  21. Pourcher V, Robineau O, Parienti JJ, et al. Factors influencing antiretroviral therapy switching in people with virologically suppressed HIV-1: a cross-sectional multicenter study in France. AIDS. 2025;39(6):695-700. doi:1097/qad.0000000000004118
  22. Olawepo JO, Pharr JR, Kabir R, Olutola A. Health care providers' perceptions about overweight and obesity among people living with human immunodeficiency virus in Nigeria. Qual Health Res. 2021;31(11):2147-2157. doi:1177/10497323211023164
  • Received Date: 22 January 2025
  • Revised Date: 17 June 2025
  • Accepted Date: 29 July 2025
  • First Published Date: 02 August 2025
  • Publish Date: 01 December 2025