Research Highlights Changes in Body Mass Index, Blood Pressure, and Lipid Profile After Efavirenz or Dolutegravir-Based Therapy Initiation in Acute HIV Infection

Strategic Insights -

A recent study has shed light on changes in body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), and lipid profile in patients initiating efavirenz/tenofovir disoproxil fumarate/emtricitabine (EFV/TDF/FTC) or dolutegravir/abacavir/lamivudine (DTG/ABC/3TC) antiretroviral therapy (ART) regimens during acute HIV infection (AHI). The research, conducted by a team from the Walter Reed Army Institute of Research and supported by the Henry M. Jackson Foundation, National Institute of Allergy and Infectious Diseases, National Institute of Mental Health, and National Institute of Neurological Disorders and Stroke, analyzed data from 304 Thai RV254 AHI cohort participants.

Key Takeaways:

  • The study compared the effects of efavirenz/tenofovir disoproxil fumarate/emtricitabine (EFV/TDF/FTC) and dolutegravir/abacavir/lamivudine (DTG/ABC/3TC) antiretroviral therapy (ART) regimens on body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), and lipid profile in patients with acute HIV infection (AHI).
  • The two groups of participants were similar in age, sex, levels of plasma HIV RNA, CD4+ and CD8+ T-cell counts, and CD4/CD8 ratios at the initiation of ART.
  • However, participants taking DTG/ABC/3TC had a higher BMI and lower SBP than those taking EFV/TDF/FTC (p < 0.001).
  • Clinicians should remain vigilant regarding blood pressure and cholesterol changes following ART initiation, especially in those with pre-existing cardiovascular risk factors.
  • The study concluded that body weight changes, blood pressure changes, and lipid profile changes are significant factors to consider in the management of AHI patients.

Statistics:

  • 304 Thai RV254 AHI cohort participants were included in the study.
  • 160 (53%) initiated EFV/TDF/FTC and 144 (47%) DTG/ABC/3TC during AHI.
  • Assessments were conducted at weeks 0, 24, 48, 72, and 96.
  • Longitudinal changes were compared using linear mixed models.

Sources:

  • Blood pressure and metabolic outcomes after efavirenz- or dolutegravir-based therapy started in acute HIV infection. HIV Medicine, 2025;26(10):1619-1625.
  • HIV Medicine can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - www.wiley.com/; HIV Medicine - onlinelibrary.wiley.com/journal/10.1111/(ISSN)1468-1293)
  • The citation for this news report is: NewsRx. Researchers from Walter Reed Army Institute of Research Report Details of New Studies and Findings in the Area of U.S. Military Research (Blood pressure and metabolic outcomes after efavirenz- or dolutegravir-based therapy started in acute HIV ...). AIDS Weekly. October 20, 2025; p 214.