Overweight and Obesity Among People Living With HIV on Dolutegravir- and Efavirenz-Based Therapies: A Comparative Cross-Sectional Study

Background: Overweight and obesity have arisen as major public health challenges, affecting not just the general population but also people living with human immunodeficiency virus (HIV) (PLWH). Obesity and being overweight are both risk factors for heart disease and other related complications. However, little is known in our setting. As a result, this study was conducted to evaluate the prevalence of overweight and obesity and its associated factors among PLWH on dolutegravir (DTG)- and efavirenz (EFV)-based therapies. Methods: An institution-based comparative cross-sectional study was carried out from June 30, 2021, to August 30, 2021. We purposively recruited 128 participants who have been on DTG (n = 64)- and EFV (n = 64)-based regimens for ≥ 6 months. Demographic, anthropometric, laboratory, and clinical data were collected using a structured questionnaire. The data were entered into EpiData Version 4.6 and analyzed using SPSS Version 26.0. Multivariable logistic regression was utilized to identify the factors that are associated with being overweight or obese, and the significance level was set at p < 0.05. Result: The prevalence of overweight and obesity was 28.1% in the DTG-prescribed participants and 15.6% in the EFV-prescribed participants. Age ≥ 40 years (adjusted odd ratio (AOR) = 3.86; 95% confidence interval (CI): 1.08-13.73; and p=0.037), cluster of differentiation 4 (CD4) T-cell counts ≥ 500 cells/mm³ (AOR = 2.95; 95% CI: 1.01-8.59; and p=0.029), and insufficient physical activity (AOR = 4.6; 95% CI: 1.53-13.84; and p=0.007) were predictors of overweight and obesity. Conclusion: Overweight and obesity are not uncommon among PLWH on ART. While the difference was statistically insignificant, the prevalence of overweight and obesity was higher in patients treated with DTG compared with those treated with EFV. Older age, higher CD4 cell counts, and insufficient physical activity were associated with overweight and obesity. As a result, healthcare providers must understand the health implications of obesity and consider incorporating targeted weight control programs into standard HIV treatment.