Blood pressure, weight change and incident hypertension after switching to dolutegravir in treatment-experienced people with HIV
Bibliographic record
Abstract
OBJECTIVE: Dolutegravir (DTG) is recommended in WHO guidelines and has reportedly been associated with excess gain in body weight (BW). DESIGN: In the prospective LighTen Cohort Study (ClinicalTrials.gov NCT02381275) we evaluated changes in BW and blood pressure (BP) of people with HIV (PWH) who had initiated tenofovir (TDF)/lamivudine (3TC)/efavirenz (EFV; TLE). Follow-up continued after participants had been switched to TDF/3TC/DTG (TLD) in 2019. METHODS: From the electronic medical record system, we retrieved data on BW and systolic BP of LighTen Cohort Study participants (age ≥18 years), who were still in care. We modelled BW and systolic BP over time utilizing interrupted time series (ITS) considering repeated measurements and adjusting for age and sex. Incident hypertension was defined as office BP ≥140/90 mmHg using ≥2 measurements on ≥2 consecutive visits. RESULTS: Data of 543 PWH (317 females) were analysed. ITS showed an increase in BW of 1.24 kg/year on TLE with a minimal contribution (36.5 g/year) during DTG treatment, in contrast to the change in systolic BP: 0.33mmHg/year on TLE vs. 2.63 mmHg/year on DTG. Incident hypertension in previously normotensive PWH was confirmed in 5.4% (while on TLE) vs. 11.0% (while on TLD). CONCLUSIONS: Following the initial increase in BW on TLE, a larger increase in BP and a higher risk of incident hypertension was associated with switching antiretroviral therapy from TLE to TLD. Focussing on BP control while on DTG and timely initiation of antihypertensive drug therapy can help to reduce the burden of hypertension in PWH with their inherent increased cardiovascular risk.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".