Assessing risk factors for overweight among people living with HIV transitioning to post-dolutegravir-based regimens in Homa Bay County, Kenya

Background: Viral suppression and treatment outcomes have significantly improved for people living with HIV (PLHIV) on Dolutegravir (DTG)-based regimens. More recently, however, there has been evidence that DTGs are associated with weight gain and therefore overweight and obesity, and the associated non-communicable diseases. The aim of this study was to evaluate risk factors for overweight in PLHIV transitioned onto DTG-based regimens in Homa Bay County in Kenya. Methods: A mixed-methods study that combined retrospective cohort and cross-sectional approach was used on PLHIV aged ≥18 years receiving DTG-based regimens for ≥6 months in 7 public health facilities in Homa Bay county. Data was collected on 540 people (90% response rate) using medical record review, structured questionnaires and a food frequency questionnaire. SPSS 27 was used to perform descriptive statistics, chi-square tests, Pearson's correlation, t test, and multivariate regression. Results: The results indicated that 4.2 kg weight gain occurred after transition to the DTG-based regimens. There was more weight gain in female participants than in male. Socio-demographic characteristics (χ²=18.6, p=0.005; r=0.41, p=0.01), dietary factors (r=0.47, p<0.001) and medication adherence (r=0.41, p=0.01) were significantly associated with weight gain. Conclusions: Socio-demographic factors, dietary patterns and treatment adherence significantly influenced weight gain in PLHIV on DTG-based treatment. Clinically embedding chronic disease monitoring, nutrition counseling and non-communicable disease testing into HIV care could help manage downstream health implications.