ART class was not associated with excessive gestational weight gain (GWG), although people with HIV who started an integrase inhibitor-based ART regimen during pregnancy did experience higher weekly GWG in the second and third trimesters, according to findings published in AIDS. Jennifer Jao, MD, and colleagues examined GWG in 1,477 pregnancies among 1,282 people with HIV, including 847 pregnancies in which ART was started at conception (ART-C) and 630 pregnancies in which ART was started during pregnancy (ART I). The researchers reported proportions of GWG as excessive (44%), adequate (24%), and inadequate (32%), and they observed no associations of ART class with excessive GWG overall. However, among ART-I pregnancies with overweight pre-pregnancy BMI, protease inhibitor (PI)-, non-nucleoside reverse transcriptase inhibitor-, and nucleoside reverse
transcriptase inhibitor-based ART were associated with significantly lower GWG per week
than integrase inhibitor (INSTI)-based ART (mean differences: -0.14, -0.27, and -0.29 kg/
week, respectively). Among ART-I pregnancies with obese pre-pregnancy BMI, lower weekly
GWG was also seen for PI- versus INSTI-based ART (mean difference: -0.14 kg/week).