Cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide
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Profound weight gain: case report An approximately 57-year-old woman developed profound weight gain during treatment with cobicistat/elvitegravir/ emtricitabine/tenofovir alafenamide for HIV infection. The woman, who was diagnosed with HIV infection in 2003 at the age of 43 years, started receiving tenofovir disoproxil/ emtricitabine/efavirenz [Atripla]. She concomitantly received fluoxetine and ranitidine. Her medical history was significant for mood disorder, gastrooesophageal reflux disease, obesity and intermittent heroin use. During November 2011 to November 2016 (while receiving tenofovir disoproxil/emtricitabine/efavirenz), her weight fluctuated between 121kg to134kg, and her BMI ranged between 41 and 49. Her treatment with tenofovir disoproxil/emtricitabine/efavirenz remained unchanged until December 2016 with no associated complications and undetectable HIV viral load. In December 2016 (at an approximate age of 56 years), her treatment was switched to cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide [Genvoya; dosage and route not stated]. However, in June 2017, six months after the initiation of cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide therapy (at an approximate age of 57 years), her weight increased to 149kg and BMI to 55. Thirteen months after the initiation of cobicistat/elvitegravir/ emtricitabine/tenofovir alafenamide (in January 2018), her weight increased to 164kg and BMI to 60. At this time, she reported no changes in her mood, eating habits or daily routine, and there were no changes in her other medications. It was considered that her profound weight gain was related to cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide therapy. The woman’s therapy with cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide was switched back to tenofovir disoproxil/ emtricitabine/efavirenz in January 2018. As a result, her weight steadily declined and returned to the baseline weight (observed in 2016) after two years following the switch. In February 2020 (at the last clinical appointment), her weight and BMI were found to be 128kg and 47, respectively. Max B, et al. Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide discontinuation and return to normal weight. International Journal of STD and AIDS : 1-4, 11 Nov 803520060 2020. Available from: URL: http://doi.org/10.1177/0956462420964341
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Reactions 12 Dec 2020 No. 1834
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