Initial HIV Therapy for Adults and Treatment-Associated Weight Gain: The Opti-DOR Randomized Clinical Trial.

A regimen with doravirine, lamivudine, and tenofovir disoproxil fumarate results in significantly less weight gain than dolutegravir, emtricitabine, and tenofovir alafenamide in adults with HIV.

• Why it matters: Weight gain associated with certain antiretroviral regimens may increase cardiometabolic risks in people with HIV, highlighting the need for safer treatment options.
• What they did: The study was an open-label, noninferiority randomized clinical trial involving 600 ART-naive adults in South Africa, comparing viral suppression and weight change over 48 weeks between two regimens.
• The result: The doravirine-based regimen achieved noninferior viral suppression and was linked to a median weight gain of 3.0 kg versus 5.0 kg with the dolutegravir regimen, enabling safer treatment choices.