549. Weight and BMI Changes in HIV-Infected Virologically Suppressed Adults after Switching to an Elvitegravir- or Dolutegravir-Containing Regimen

Background Weight gain in patients with HIV infection taking antiretroviral therapy (ART) is of great concern, given the increased risk of diabetes mellitus and cardiovascular disease in this population. Recent reports suggest that weight gain may be associated with a new ART class, the integrase strand transfer inhibitors (INSTIs). The effect of the INSTIs elvitegravir and dolutegravir on weight and BMI in virologically suppressed patients with HIV infection has not been fully elucidated. Methods This retrospective observational study evaluated weight and BMI changes in aviremic HIV-infected patients who switched to an elvitegravir- or dolutegravir-containing regimen. Patients ≥18 years old on a stable ART regimen seen at the University of Utah Health Infectious Diseases Clinic between January 1, 2012 and February 28, 2017 who switched to an elvitegravir- or dolutegravir-containing regimen for at least 1 year were included. Exclusion criteria included patients with hypogonadism or a thyroid disorder, patients who received medications that impact weight (including steroids, levothyroxine, and metformin), and patients with two consecutive HIV viral load values >200 copies/mL during the study period. Body weight and BMI values collected prior to and ~1 year after the switch date were compared using paired t-tests. Results A total of 118 patients met study criteria and were included in the analysis. Eighty-eight (74.6%) patients were switched to a dolutegravir-containing regimen and 30 (25.4%) patients were switched to a regimen containing elvitegravir. Pre-measurements were taken 5.9 (±13.3) days prior to the switch date (range: −83, +1 days), and post-measurements were taken 310 (±56) days following the medication change (range: 186, 399 days). Weight increased on average 2.3 kg (95% CI: 1.6, 3; P < 0.001), and BMI increased on average 0.8 kg/m2 (95% CI: 0.5, 1; P < 0.001). Conclusion Aviremic patients with HIV gained an average of 2.3 kg ~310 days after switching to an elvitegravir- or dolutegravir-containing regimen. The average increase in BMI was 0.8 kg/m2. Weight gain may need to be included as a consideration when using an elvitegravir- or dolutegravir-containing regimen. Disclosures All authors: No reported disclosures.