In HIV-negative people, clinical obesity is associated with a wide range of clinical consequences: for example, Alzheimer’s disease, adverse birth outcomes and cardiovascular disease. In HIV clinical trials and cohort studies, the risk of weight gain and clinical obesity is higher for women, black people, and those taking integrase inhibitors - in particular dolutegravir and bictegravir. The use of TDF (but not TAF) is associated with weight loss, which could compensate for the effects of integrase inhibitors.
In this overview talk, new results from the NAMSAL and ADVANCE trials will be presented. These trials included treatment of black women with dolutegravir and tenofovir alafenamide. This combination is expected to show the greatest risk of clinical obesity.