Changes in Body Mass Index in Children and Adolescents Living With Human Immunodeficiency Virus in Europe and Thailand Starting Dolutegravir - Report - MDSpire

Changes in Body Mass Index in Children and Adolescents Living With Human Immunodeficiency Virus in Europe and Thailand Starting Dolutegravir

  • By

  • The Epidemiology of Pregnancy and Paediatric Infections International Cohort Collaboration (EPPICC) Study Group

  • Elizabeth Chappell

  • Siobhan Crichton

  • Intira Jeannie Collins

  • Giorgia Dalla Valle

  • Charlotte Duff

  • Kate Edgar

  • Carlo Giaquinto

  • Charlotte Jackson

  • Ali Judd

  • Laura Mangiarini

  • John O’Rourke

  • Karen Scott

  • Claire Thorne

  • Tessa Goetghebuer

  • Marc Hainaut

  • Wivine Tremerie

  • Marc Delforge

  • Thomas Ulrik Hoffmann

  • Sannie Brit Nordly

  • Marla B Braun

  • Vana Spoulou

  • Luisa Galli

  • Elena Chiappini

  • Catiuscia Lisi

  • Carlotta Montagnani

  • Elisabetta Venturini

  • Magdalena Marczyńska

  • Jolanta Popielska

  • Maria Pokorska-Śpiewak

  • Agnieszka Ołdakowska

  • Konrad Zawadka

  • Magdalena Pluta

  • Małgorzata Doroba

  • Luminita Ene

  • María José Mellado

  • Luis Escosa

  • Milagros García-López Hortelano

  • Talía Sainz

  • Carlos Grasa

  • Paula Rodríguez

  • Jose Tomás Ramos

  • Pablo Rojo

  • Luis Prieto-Tato

  • Cristina Epalza

  • Alfredo Tagarro

  • Sara Domínguez

  • Álvaro Ballesteros

  • Marta Illán

  • Arantxa Berzosa

  • Sara Guillén

  • Beatriz Soto

  • María Luisa Navarro

  • Jesús Saavedra

  • Mar Santos

  • Elena Rincón

  • David Aguilera

  • Begoña Santiago

  • Beatriz Lázaro Martín

  • Andrea López Suárez

  • Amanda Bermejo

  • María Penín

  • Jorge Martínez

  • Katie Badillo

  • Ana Belén Jiménez

  • Adriana Navas

  • Eider Oñate

  • Itziar Pocheville

  • Elisa Garrote

  • Elena Colino

  • Olga Afonso

  • Jorge Gómez Sirvent

  • Mónica Garzón

  • Vicente Román

  • Raquel Angulo

  • Olaf Neth

  • Lola Falcón

  • Pedro Terol

  • Juan Luis Santos

  • Álvaro Vázquez

  • Begoña Carazo

  • Antonio Medina

  • Francisco Lendínez

  • Mercedes Ibáñez

  • Estrella Peromingo

  • María Isabel Sánchez

  • Beatriz Ruiz

  • Ana Grande

  • Francisco José Romero

  • Carlos Pérez

  • Alejandra Méndez

  • Laura Calle-Miguel

  • Virginia Courel del Río

  • Marta Pareja

  • Begoña Losada

  • Mercedes Herranz

  • Matilde Bustillo

  • Pilar Collado

  • José Antonio Couceiro

  • Leticia Vila

  • Consuelo Calviño

  • Ana Isabel Piqueras

  • Manuel Oltra

  • César Gavilán

  • Elena Montesinos

  • Marta Dapena

  • Beatriz Jiménez

  • Ana Gloria Andrés

  • Víctor Marugán

  • Carlos Ochoa

  • Ana Isabel Menasalvas

  • Eloísa Cervantes

  • Cristina Díez

  • Ignacio Bernardino

  • María Luisa Montes

  • Eulalia Valencia

  • Ana Delgado

  • Rafael Rubio

  • Federico Pulido

  • Otilia Bisbal

  • Alfonso Monereo Alonso

  • Juan Berenguer

  • Cristina Díez

  • Teresa Aldamiz

  • Francisco Tejerina

  • Juan Carlos Bernaldo de Quirós

  • Belén Padilla

  • Raquel Carrillo

  • Pedro Montilla

  • Elena Bermúdez

  • Maricela Valerio

  • Jose Sanz

  • Alejandra Gimeno

  • Miguel Cervero

  • Rafael Torres

  • Santiago Moreno

  • María Jesús Perez

  • Santos del Campo

  • Pablo Ryan

  • Jesus Troya

  • Jesus Sanz

  • Juan Losa

  • Rafael Gomez

  • Miguel Górgolas

  • Alberto Díaz

  • Sara de la Fuente

  • Jose Antonio Iribarren

  • Marıa Jose Aramburu

  • Lourdes Martinez

  • Ane Josune Goikoetxea

  • Sofia Ibarra

  • Mireia de la Peña

  • Víctor Asensi

  • Michele Hernandez

  • María Remedios Alemán

  • Ricardo Pelazas

  • María del Mar Alonso

  • Ana María López

  • Dácil García

  • Jehovana Rodriguez

  • Miguel Angel Cardenes

  • Manuel A Castaño

  • Francisco Orihuela

  • Inés Pérez

  • Mª Isabel Mayorga

  • Luis Fernando Lopez-Cortes

  • Cristina Roca

  • Silvia Llaves

  • Marıa Jose Rios

  • Jesus Rodriguez

  • Virginia Palomo

  • Juan Pasquau

  • Coral Garcia

  • Jose Hernandez

  • Clara Martinez

  • Antonio Rivero

  • Angela Camacho

  • Dolores Merino

  • Miguel Raffo

  • Laura Corpa

  • Elisa Martinez

  • Fernando Mateos

  • Jose Javier Blanch

  • Miguel Torralba

  • Piedad Arazo

  • Gloria Samperiz

  • Celia Miralles

  • Antonio Ocampo

  • Guille Pousada

  • Alvaro Mena

  • Marta Montero

  • Miguel Salavert

  • Maria Jose Galindo

  • Natalia Pretel

  • Joaquín Portilla

  • Irene Portilla

  • Felix Gutierrez

  • Mar Masia

  • Cati Robledano

  • Araceli Adsuar

  • Carmen Hinojosa

  • Begoña Monteagudo

  • Pablo Bachiller

  • Jesica Abadía

  • Carlos Galera

  • Helena Albendin

  • Marian Fernandez

  • Jose Ramon Blanco

  • Pere Soler-Palacín

  • Maria Antoinette Frick

  • Santiago Pérez-Hoyos

  • Núria López

  • María Méndez

  • Clara Carreras

  • Borja Guarch-Ibáñez

  • Teresa Vallmanya

  • Laura Minguell-Domingo

  • Olga Calavia

  • Lourdes García

  • Maite Coll

  • Valentí Pineda

  • Neus Rius

  • Núria Rovira

  • Joaquín Dueñas

  • Clàudia Fortuny

  • Anna Gamell

  • Antoni Noguera-Julian

  • Lars Navér

  • Nora Einarsson

  • Vendela Hagås

  • Johanna Rubin

  • Sandra Soeria-Atmadja

  • Irene Alma Abela

  • Karoline Aebi-Popp

  • Alexia Anagnostopoulos

  • Manuel Battegay

  • Marc Baumann

  • Enos Bernasconi

  • Dominique Laurent Braun

  • Heiner C Bucher

  • Alexandra Calmy

  • Matthias Cavassini

  • Angela Ciuffi

  • Pierre-Alex Crisinel

  • Katharine E A Darling

  • Günter Dollenmaier

  • Andrea Duppenthaler

  • Matthias Egger

  • Luisa Elzi

  • Jan Sven Fehr

  • Jacques Fellay

  • Katyuska Francini

  • Hansjakob Furrer

  • Christoph Andreas Fux

  • Huldrych Fritz Günthard

  • Anna Hachfeld

  • David Hans-Ulrich Haerry

  • Barbara Hasse

  • Hans Hellmuth Hirsch

  • Matthias Hoffmann

  • Irene Hösli

  • Michael Huber

  • David Jackson-Perry

  • Christian R Kahlert

  • Olivia Keiser

  • Thomas Klimkait

  • Malte Kohns

  • Lisa Kottanattu

  • Roger Dimitri Kouyos

  • Helen Kovari

  • Katharina Kusejko

  • Niklaus Daniel Labhardt

  • Karoline Leuzinger

  • Begoña Martinez de Tejada

  • Catja Marzolini

  • Karin Jutta Metzner

  • Nicolas Müller

  • Johannes Nemeth

  • Dunja Nicca

  • Julia Notter

  • Paolo Paioni

  • Giuseppe Pantaleo

  • Matthieu Perreau

  • Christian Polli

  • Elisabetta Ranieri

  • Andri Rauch

  • Luisa Paola Salazar-Vizcaya

  • Patrick Schmid

  • Olivier Segeral

  • Roberto F Speck

  • Marcel Stöckle

  • Philip Edward Tarr

  • Lecompte Marthe Than

  • Alexandra Trkola

  • Noémie Wagner

  • Gilles Wandeler

  • Maja Weisser

  • Sabine Yerly

  • Rachaneekorn Nadsasarn

  • Chutima Saisaengjan

  • Patama Deeklum

  • Phattharapa Khamkhen

  • Lucksanapon Pitikawinwong

  • Nattakarn Tantawarak

  • Pope Kosalaraksa

  • Chanasda Kakkaew

  • Tetiana Kaleeva

  • Yulia Baryshnikova

  • Iryna Raus

  • Olena Glutshenko

  • Halyna Sherstiuk

  • Iryna Shkurka

  • Natalia Delikhovska

  • Iryna Popova

  • Tetiana Golubieva

  • Alla Volokha

  • Ruslan Malyuta

  • Claire Thorne

  • October 11, 2025

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Impact of Dolutegravir on BMI Changes in Pediatric and Adolescent HIV Patients

Overview

This study evaluated body mass index-for-age z-score (zBMI) changes in children and adolescents living with HIV (CALHIV) initiating dolutegravir (DTG) across Europe and Thailand. Results showed modest increases in zBMI after DTG initiation, with the greatest gains in younger children, those on tenofovir alafenamide (TAF), and variations by sex and ethnicity. Comparisons with protease inhibitor (PI)-based regimens revealed no significant difference in zBMI changes over 96 weeks.

Background

Dolutegravir (DTG) is a preferred integrase strand transfer inhibitor recommended for HIV treatment in children, adolescents, and adults. While excess weight gain has been reported in adults on DTG, data in pediatric populations remain limited and inconsistent. Prior studies have suggested that weight gain may be influenced by factors such as coadministration with TAF and prior antiretroviral regimens. Understanding growth trajectories on DTG in children is critical as DTG is increasingly used globally.

Data Highlights

CharacteristicValue
Number of CALHIV on DTG948
Median age at DTG start13.7 years (IQR 11.1–15.6)
Median baseline zBMI0.31 (IQR −0.64 to 1.19)
Percentage female50%
Percentage Black ethnicity48%
Overweight or obese at DTG start30%
Mean zBMI change 48 weeks before DTG0.07 (95% CI 0.03–0.11)
Mean zBMI change 48 weeks after DTG0.13 (95% CI 0.09–0.16)
Mean zBMI change at 96 weeks on DTG0.20 (95% CI 0.14–0.27)
Mean zBMI change at 96 weeks on PI-based regimens0.30 (95% CI 0.13–0.48)
p-value for zBMI change difference DTG vs PI0.354

Key Findings

  • CALHIV experienced a modest increase in zBMI after starting DTG, with mean change of 0.20 at 96 weeks.
  • The largest zBMI increases were observed in children aged 6–11 years, males of "other" ethnicity, Black females, and those receiving TAF.
  • Baseline low zBMI was associated with greater increases on DTG.
  • No statistically significant difference in zBMI change was found between DTG- and PI-based regimens over 96 weeks.
  • Approximately 30% of participants were overweight or obese at DTG initiation.
  • Weight gain trends on DTG were consistent with prior observations in pediatric clinical trials and real-world cohorts.

Clinical Implications

Clinicians should monitor growth and weight trajectories in CALHIV initiating DTG, especially in younger children and those on TAF-containing regimens. The comparable zBMI changes between DTG and PI regimens suggest that DTG does not confer excess weight gain risk relative to PIs in this population. Awareness of demographic and treatment-related factors influencing weight gain can guide individualized care and counseling.

Conclusion

Dolutegravir initiation in children and adolescents living with HIV is associated with modest increases in BMI-for-age z-scores, particularly in specific subgroups, but overall weight gain is comparable to protease inhibitor regimens. These findings support the continued use of DTG with appropriate growth monitoring in pediatric HIV care.

References

  1. ODYSSEY Trial -- Weight gain on DTG vs standard of care in children
  2. CHAPAS-4 Trial -- BMI changes on DTG and other regimens in African children
  3. EPPICC Cohort Collaboration 2023 -- Impact of Dolutegravir Initiation on BMI in CALHIV

Original Source(s)

Changes in Body Mass Index in Children and Adolescents Living With Human Immunodeficiency Virus in Europe and Thailand Starting Dolutegravir

  • by The Epidemiology of Pregnancy and Paediatric Infections International Cohort Collaboration (EPPICC) Study Group, Elizabeth Chappell, Siobhan Crichton, Intira Jeannie Collins, Giorgia Dalla Valle, Charlotte Duff, Kate Edgar, Carlo Giaquinto, Charlotte Jackson, Ali Judd, Laura Mangiarini, John O’Rourke, Karen Scott, Claire Thorne, Tessa Goetghebuer, Marc Hainaut, Wivine Tremerie, Marc Delforge, Thomas Ulrik Hoffmann, Sannie Brit Nordly, Marla B Braun, Vana Spoulou, Luisa Galli, Elena Chiappini, Catiuscia Lisi, Carlotta Montagnani, Elisabetta Venturini, Magdalena Marczyńska, Jolanta Popielska, Maria Pokorska-Śpiewak, Agnieszka Ołdakowska, Konrad Zawadka, Magdalena Pluta, Małgorzata Doroba, Luminita Ene, María José Mellado, Luis Escosa, Milagros García-López Hortelano, Talía Sainz, Carlos Grasa, Paula Rodríguez, Jose Tomás Ramos, Pablo Rojo, Luis Prieto-Tato, Cristina Epalza, Alfredo Tagarro, Sara Domínguez, Álvaro Ballesteros, Marta Illán, Arantxa Berzosa, Sara Guillén, Beatriz Soto, María Luisa Navarro, Jesús Saavedra, Mar Santos, Elena Rincón, David Aguilera, Begoña Santiago, Beatriz Lázaro Martín, Andrea López Suárez, Amanda Bermejo, María Penín, Jorge Martínez, Katie Badillo, Ana Belén Jiménez, Adriana Navas, Eider Oñate, Itziar Pocheville, Elisa Garrote, Elena Colino, Olga Afonso, Jorge Gómez Sirvent, Mónica Garzón, Vicente Román, Raquel Angulo, Olaf Neth, Lola Falcón, Pedro Terol, Juan Luis Santos, Álvaro Vázquez, Begoña Carazo, Antonio Medina, Francisco Lendínez, Mercedes Ibáñez, Estrella Peromingo, María Isabel Sánchez, Beatriz Ruiz, Ana Grande, Francisco José Romero, Carlos Pérez, Alejandra Méndez, Laura Calle-Miguel, Virginia Courel del Río, Marta Pareja, Begoña Losada, Mercedes Herranz, Matilde Bustillo, Pilar Collado, José Antonio Couceiro, Leticia Vila, Consuelo Calviño, Ana Isabel Piqueras, Manuel Oltra, César Gavilán, Elena Montesinos, Marta Dapena, Beatriz Jiménez, Ana Gloria Andrés, Víctor Marugán, Carlos Ochoa, Ana Isabel Menasalvas, Eloísa Cervantes, Cristina Díez, Ignacio Bernardino, María Luisa Montes, Eulalia Valencia, Ana Delgado, Rafael Rubio, Federico Pulido, Otilia Bisbal, Alfonso Monereo Alonso, Juan Berenguer, Cristina Díez, Teresa Aldamiz, Francisco Tejerina, Juan Carlos Bernaldo de Quirós, Belén Padilla, Raquel Carrillo, Pedro Montilla, Elena Bermúdez, Maricela Valerio, Jose Sanz, Alejandra Gimeno, Miguel Cervero, Rafael Torres, Santiago Moreno, María Jesús Perez, Santos del Campo, Pablo Ryan, Jesus Troya, Jesus Sanz, Juan Losa, Rafael Gomez, Miguel Górgolas, Alberto Díaz, Sara de la Fuente, Jose Antonio Iribarren, Marıa Jose Aramburu, Lourdes Martinez, Ane Josune Goikoetxea, Sofia Ibarra, Mireia de la Peña, Víctor Asensi, Michele Hernandez, María Remedios Alemán, Ricardo Pelazas, María del Mar Alonso, Ana María López, Dácil García, Jehovana Rodriguez, Miguel Angel Cardenes, Manuel A Castaño, Francisco Orihuela, Inés Pérez, Mª Isabel Mayorga, Luis Fernando Lopez-Cortes, Cristina Roca, Silvia Llaves, Marıa Jose Rios, Jesus Rodriguez, Virginia Palomo, Juan Pasquau, Coral Garcia, Jose Hernandez, Clara Martinez, Antonio Rivero, Angela Camacho, Dolores Merino, Miguel Raffo, Laura Corpa, Elisa Martinez, Fernando Mateos, Jose Javier Blanch, Miguel Torralba, Piedad Arazo, Gloria Samperiz, Celia Miralles, Antonio Ocampo, Guille Pousada, Alvaro Mena, Marta Montero, Miguel Salavert, Maria Jose Galindo, Natalia Pretel, Joaquín Portilla, Irene Portilla, Felix Gutierrez, Mar Masia, Cati Robledano, Araceli Adsuar, Carmen Hinojosa, Begoña Monteagudo, Pablo Bachiller, Jesica Abadía, Carlos Galera, Helena Albendin, Marian Fernandez, Jose Ramon Blanco, Pere Soler-Palacín, Maria Antoinette Frick, Santiago Pérez-Hoyos, Núria López, María Méndez, Clara Carreras, Borja Guarch-Ibáñez, Teresa Vallmanya, Laura Minguell-Domingo, Olga Calavia, Lourdes García, Maite Coll, Valentí Pineda, Neus Rius, Núria Rovira, Joaquín Dueñas, Clàudia Fortuny, Anna Gamell, Antoni Noguera-Julian, Lars Navér, Nora Einarsson, Vendela Hagås, Johanna Rubin, Sandra Soeria-Atmadja, Irene Alma Abela, Karoline Aebi-Popp, Alexia Anagnostopoulos, Manuel Battegay, Marc Baumann, Enos Bernasconi, Dominique Laurent Braun, Heiner C Bucher, Alexandra Calmy, Matthias Cavassini, Angela Ciuffi, Pierre-Alex Crisinel, Katharine E A Darling, Günter Dollenmaier, Andrea Duppenthaler, Matthias Egger, Luisa Elzi, Jan Sven Fehr, Jacques Fellay, Katyuska Francini, Hansjakob Furrer, Christoph Andreas Fux, Huldrych Fritz Günthard, Anna Hachfeld, David Hans-Ulrich Haerry, Barbara Hasse, Hans Hellmuth Hirsch, Matthias Hoffmann, Irene Hösli, Michael Huber, David Jackson-Perry, Christian R Kahlert, Olivia Keiser, Thomas Klimkait, Malte Kohns, Lisa Kottanattu, Roger Dimitri Kouyos, Helen Kovari, Katharina Kusejko, Niklaus Daniel Labhardt, Karoline Leuzinger, Begoña Martinez de Tejada, Catja Marzolini, Karin Jutta Metzner, Nicolas Müller, Johannes Nemeth, Dunja Nicca, Julia Notter, Paolo Paioni, Giuseppe Pantaleo, Matthieu Perreau, Christian Polli, Elisabetta Ranieri, Andri Rauch, Luisa Paola Salazar-Vizcaya, Patrick Schmid, Olivier Segeral, Roberto F Speck, Marcel Stöckle, Philip Edward Tarr, Lecompte Marthe Than, Alexandra Trkola, Noémie Wagner, Gilles Wandeler, Maja Weisser, Sabine Yerly, Rachaneekorn Nadsasarn, Chutima Saisaengjan, Patama Deeklum, Phattharapa Khamkhen, Lucksanapon Pitikawinwong, Nattakarn Tantawarak, Pope Kosalaraksa, Chanasda Kakkaew, Tetiana Kaleeva, Yulia Baryshnikova, Iryna Raus, Olena Glutshenko, Halyna Sherstiuk, Iryna Shkurka, Natalia Delikhovska, Iryna Popova, Tetiana Golubieva, Alla Volokha, Ruslan Malyuta, Claire Thorne

  • October 11, 2025

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