Significant body composition changes have been documented following the commencement of combination antiviral medication (cART). For a study, researchers compared the body composition parameters and proinflammatory/endocrine profiles of chronically infected and virologically suppressed (VL < 50 copies/ml) men (≥50 years old) living with HIV (MLWH) who were switched to integrase inhibitors (INSTI) to age-matched MLWH on integrase inhibitor-free (non-INSTI) regimens, taking into account neighborhood-level measures of socioeconomic status (SES). Furthermore, as controls, they chose previously reported HIV-seronegative men of the same age.

In 56 MLWH, they examined plasma proinflammatory/endocrine markers and employed dual-energy X-ray absorptiometry to evaluate body composition characteristics. They compared body composition to that of 450 HIV-seronegative males of similar age from a publically available dataset. Body composition and plasma proinflammatory/endocrine markers in the MLWH group were compared between people on INSTI and non-INSTI regimens while controlling for socioeconomic status.

Men with HIV had a higher android/gynoid ratio than HIV-seronegative men (P<0.001). INSTI use in MLWH was related to decreased adiposity measurements compared to non-INSTI, but these effects vanished when SES was controlled for. INSTI and non-INSTI MLWH exhibited comparable proinflammatory/endocrine markers.

Among cART-experienced MLWH, those taking INSTI-containing regimens had marginally lower adiposity than non-INSTI MLWH, albeit these differences were explained by SES. Future research on the association between INSTI usage and body composition should take SES into account.