PrEP’s Effect on Body Fat and Cholesterol Is Minimal

[Jim Allen]

More good news or reassurance for PrEP users

Truvada appeared to temporarily prevent some weight gain and reduce cholesterol slightly in a recent study.

This substudy included 251 participants randomized to receive Truvada and 247 individuals randomized to receive a placebo. The members of this overall study group received fasting blood lipid tests and dual X-ray absorptiometry scans of their entire body, hip and spine upon their entry into the study and every 24 weeks afterward, including after they stopped receiving PrEP. At each study visit while they were receiving PrEP, the participants provided blood samples that the investigators tested to determine how much Truvada was in their system.

Participants in the Truvada group received a median 64 weeks of exposure to the drug.

Truvada did not affect the participants’ lean body mass. Both those in the Truvada and placebo groups experienced weight gain, although those who received the study drug saw less weight gain through week 72 of follow-up. This difference was a result of less fat gain among those in the Truvada group. The median percentage increase in body fat was 3.8 percentage points lower among those who received the study drug, compared with those who received the placebo.

This difference in body fat gain was not apparently a result of nausea, which is a common side effect of Truvada, particularly during the first few weeks of daily use (for most people on PrEP, this side effect dissipates). At week 24 of follow-up, those who experienced nausea did not experience a different weight-gain rate compared with those who did not experience the side effect.

There was no difference in triglyceride levels between the two study groups, but by week 48 of follow-up, those in the Truvada group had a median HDL cholesterol level 3.9 milligrams per deciliter lower than those in the placebo group.

Truvada was not associated with lipodystrophy, which is the abnormal distribution of body fat that is definitively linked with a few antiretroviral drugs that are much older than Truvada and are no longer commonly used to treat HIV.

Full posting:
https://www.poz.com/article/preps-effect-body-fat-cholesterol-minimal