Background Integrase strand transfer inhibitors (INSTIs) and the menopausal transition have separately been associated with body composition changes in women with HIV (WWH), but their interaction is unknown. Methods From 2006-2019, 1131 non-pregnant WWH with viral suppression [(419 who switched to INSTI (INSTI+); 712 who did not switch (INSTI–)] and 887 women without HIV (WWOH) from the Women’s Interagency HIV Study were included. Mixed effect models were used to evaluate change in waist circumference (WC) and BMI by menopausal phase defined using anti-Müllerian hormone, a biomarker of ovarian reserve. Results During premenopause, WWH had increases in WC (INSTI+: 0.01cm per 6 month (mo); 95%CI:-0.29,0.32 and INSTI-: 0.22cm per 6mo;95%CI:-0.01,0.44) that were not statistically significantly different from WWOH; there was also little difference by INSTI status. In late perimenopause, INSTI+ had faster increases in WC (0.37cm per 6mo;95%CI:0.15,0.60) while INSTI- had smaller increases (0.14cm per 6mo;95%CI:-0.06,0.34) compared to WWOH. In menopause, INSTI+ had faster increases peaking at 43mo then declining while INSTI- had smaller increases (0.14cm per 6mo;95%CI:-0.02,0.30). Compared to INSTI-, in late perimenopause, INSTI+ had 0.26 cm per 6mo (95%CI:0.02,0.50) faster linear increases in WC and in menopause, INSTI+ was associated with faster increases peaking at 41mo. BMI trajectories were similar to WC in late peri- and menopausal women. Conclusions Switching to an INSTI-based regimen during late peri- and menopause is associated with faster increases in WC and BMI when compared to women who did not switch. Menopausal status should be considered when switching to an INSTI.

中文翻译：

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在更年期过渡期间改用整合酶链转移抑制剂与 HIV 感染女性的体能成分变化加速有关


背景 整合酶链转移抑制剂 （INTI） 和绝经过渡分别与 HIV 感染女性 （WWH） 的身体成分变化有关，但它们的相互作用尚不清楚。方法 从 2006 年到 2019 年，纳入了 1131 名病毒抑制的非妊娠 WWH [（419 名改用 INSTI （INSTI+）;712 名未改用 （INSTI–）] 和 887 名未感染 HIV 的妇女 （WWOH） 来自女性机构间 HIV 研究。使用混合效应模型评估使用抗苗勒管激素（卵巢储备的生物标志物）定义的绝经期腰围 （WC） 和 BMI 的变化。结果 绝经前WWHWC增加（INSTI+：0.01cm/6个月（mo）;95%CI：-0.29,0.32和INSTI-：0.22cm/6mo;95%CI：-0.01,0.44），与 WWOH 差异无统计学意义;INSTI 状态也几乎没有差异。在围绝经期晚期，INSTI+ 的 WC 增加更快（每 6 个月 0.37 厘米;95%CI：0.15,0.60），而 INSTI- 的增加较小（每 6 个月 0.14 厘米;95%CI：-0.06,0.34）与 WWOH 相比。在更年期，INSTI+ 增加更快，在 43 个月达到峰值，然后下降，而 INSTI- 增加较小（每 6 个月 0.14 厘米;95%CI：-0.02,0.30）。与 INSTI- 相比，在围绝经期晚期，INSTI+ 在 WC 和 MENPOAGE 中的线性增加速度加快 0.26 cm/6mo （95%CI：0.02,0.50），INSTI+ 与更快的增加相关，在 41 个月达到峰值。BMI 轨迹与围绝经期晚期和绝经期妇女的 WC 相似。结论 与未转换的女性相比，在围绝经期晚期和绝经期转换为基于 INSTI 的方案与 WC 和 BMI 的快速增加相关。转为 INSTI 时应考虑绝经状态。