Changes in Body Mass Index in Children and Adolescents Living With Human Immunodeficiency Virus in Europe and Thailand Starting Dolutegravir - Scorecard - MDSpire
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Impact of Dolutegravir Initiation on Body Mass Index Changes in Pediatric and Adolescent HIV Patients in Europe and Thailand

  • 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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Clinical Scorecard: Impact of Dolutegravir Initiation on Body Mass Index Changes in Pediatric and Adolescent HIV Patients in Europe and Thailand

At a Glance

CategoryDetail
ConditionHIV infection in children and adolescents
Key MechanismsDolutegravir (DTG), an integrase strand transfer inhibitor, associated with changes in body mass index-for-age z-score (zBMI)
Target PopulationChildren and adolescents living with HIV aged 2–17 years
Care SettingRoutine pediatric HIV care across 15 observational cohorts in Europe and Thailand

Key Highlights

  • CALHIV on DTG experienced increases in zBMI over 96 weeks, with the largest gains in children aged 6–11 years, those on tenofovir alafenamide (TAF), and variations by sex and ethnicity.
  • No significant difference in zBMI change at 96 weeks between DTG- and protease inhibitor (PI)–based regimens.
  • Approximately 30% of participants were overweight or obese at DTG initiation; median baseline zBMI was 0.31.

Guideline-Based Recommendations

Diagnosis

  • Use BMI-for-age z-score (zBMI) to monitor growth and weight changes in CALHIV starting DTG.
  • Exclude children under 2 years for BMI monitoring due to reliability concerns.

Management

  • Consider potential for weight gain when initiating DTG, especially in children aged 6–11 years and those on TAF.
  • Monitor and manage overweight and obesity risks in CALHIV on DTG.
  • Recognize that weight gain on DTG is comparable to PI-based regimens over 96 weeks.

Monitoring & Follow-up

  • Perform regular zBMI assessments before and after DTG initiation, ideally up to 96 weeks.
  • Monitor demographic and clinical factors influencing weight gain, including age, sex, ethnicity, and concomitant TAF use.

Risks

  • Potential for excess weight gain and increased BMI in CALHIV on DTG, particularly with TAF coadministration.
  • Variability in weight gain by sex and ethnicity necessitates individualized monitoring.

Patient & Prescribing Data

948 children and adolescents living with HIV aged 2–17 years initiating DTG in Europe and Thailand

Median age 13.7 years; 48% Black ethnicity; 30% overweight or obese at DTG start; zBMI increased modestly over 96 weeks with no significant difference compared to PI regimens.

Clinical Best Practices

  • Use standardized zBMI measurements to assess growth trajectories in CALHIV on DTG.
  • Account for baseline weight status and demographic factors when evaluating weight changes.
  • Consider the influence of concomitant antiretrovirals such as TAF on weight gain.
  • Avoid DTG initiation in children under 2 years for BMI monitoring purposes due to measurement limitations.
  • Compare weight changes to those on alternative regimens to contextualize findings.

References

Original Source(s)

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