{"doi":"10.1093/cid/ciaf538","title":"Integrase Strand Transfer Inhibitors for Treatment-experienced Young Adults With Perinatal HIV in the US: Immunologic, Virologic, and Anthropometric Outcomes","abstract":"BACKGROUND: The efficacy of integrase strand transfer inhibitors (INSTIs) among adults with HIV is well-established, though adverse effects, particularly weight gain, are common. Comparable data for treatment-experienced adolescents and young adults with perinatally-acquired HIV (AYAPHIV) are limited. METHODS: AYAPHIV in the US-based Pediatric HIV/AIDS Cohort Study who switched to bictegravir (BIC), dolutegravir (DTG), elvitegravir (EVG), or raltegravir (RAL) from any prior regimen were eligible. Using mixed-effects models, viral load, CD4 count, weight, and body mass index were described through 2 years after switch for each INSTI. RESULTS: Among 556 AYAPHIV, there were 167 switches to BIC, 282 to DTG, 189 to EVG, and 151 to RAL. Viral suppression (<200 copies/mL) at 1 and 2 years after switch was 74% and 69% for BIC, 62% and 60% for DTG, 76% and 68% for EVG, and 58% and 52% for RAL. Mean CD4 counts were above 500 cells/mm3 after switch through 2 years for all INSTIs. Average weight gain in the first year after switch to BIC, DTG, EVG, and RAL was 0.2, 2.5, 3.8, and -0.2 kilograms for females and 2.3, 4.8, 2.9, and 2.6 kilograms for males. Among previously underweight/healthy individuals, 13%, 18%, 36%, and 12% of females and 6%, 8%, 12%, and 11% of males switching to BIC, DTG, EVG, and RAL were overweight/obese by 2 years after switch. CONCLUSIONS: Individual INSTI-based regimens among treatment-experienced AYAPHIV had moderate effectiveness with respect to viral suppression. Continued average weight gain across INSTIs raises concerns about long-term cardiometabolic sequalae.","journal":"Clinical Infectious Diseases","year":2025,"id":578717,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9221,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":920185,"name":"Alicia Jaramillo-Underwood","orcid":null,"position":1,"is_corresponding":false},{"id":795854,"name":"Brad Karalius","orcid":null,"position":2,"is_corresponding":false},{"id":975720,"name":"Tzy‐Jyun Yao","orcid":"0000-0001-7744-5057","position":3,"is_corresponding":false},{"id":436858,"name":"Russell B. 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