Centers for Disease Control and Prevention refuses to count four measles deaths in the state though doctors are ‘seeing new forms’ of disease

Treatment regimens containing integrase strand-transfer inhibitors (INSTIs) are taken lifelong by most people with HIV. The potency, tolerability, and high resistance barrier of INSTIs make them the t...

Background Central venous catheterization is the most common invasive procedure in intensive care units but remains burdened by infectious, thrombotic, and mechanical complications. Although real-time...

An official journal of the Infectious Diseases Society of America. Publishes on clinical descriptions of infections, public health, microbiology, and immunology; infection prevention; treatment evalua...

Hierarchical composite end points (HCEs) are increasingly being used in infectious diseases research. In this review aimed at educating the clinical reader

Abstract. HIV incidence among low-adherence oral PrEP users in PURPOSE 1 and 2 closely matched or slightly exceeded background HIV incidence (bHIV), suppor

Malaria control and elimination is threatened by the spread of insecticide resistance and behavioral adaptation of vectors. Whether mass administration of ivermectin, a broad-spectrum antiparasitic...

BACKGROUND: Excessive weight gain has been associated with integrase inhibitors (INSTI) and tenofovir alafenamide (TAF). ACTG A5391 evaluated whether switching to doravirine (DOR; a non-nucleoside reverse transcriptase inhibitor) with or without a switch to tenofovir disoproxil fumarate (TDF) would alter weight in people with HIV and obesity on INSTI+TAF regimens.METHODS: A phase IV, 48-week, 3-arm, open-label, multicenter randomized trial to assess whether switch from an INSTI (bictegravir, dolutegravir, or raltegravir) with TAF/emtricitabine (TAF/FTC) to either DOR+TAF/FTC or DOR+TDF/FTC results in a >5% point between-group difference in body weight change (a clinically relevant effect), compared to continuing current INSTI+TAF/FTC. We used linear regression, adjusting for sex and race, to estimate treatment effects.RESULTS: 145 participants in the US were randomized to change to DOR+TAF/FTC (n=47), DOR+TDF/FTC (n=49), or continue current treatment (n=49). At entry, median age was 49 years; BMI 34.9 kg/m2; time on INSTI+TAF/FTC 3.4 years; 49% were female, 53% Black, and 18% Hispanic/Latino. Estimated mean change in weight at 48 weeks was -0.47% (95% confidence interval [CI]: -2.09,1.14) for DOR+TAF/FTC, -2.73% (-4.22,-1.23) for DOR+TDF/FTC, and -1.84% (-3.37,-0.30) for continued INSTI+TAF/FTC. The DOR vs. INSTI (both with TAF/FTC) estimated mean difference was +1.36% points (p=0.23), and the DOR+TDF/FTC versus INSTI+TAF/FTC estimated mean difference was -0.89% points (p=0.41; Figure). Weight treatment difference 97.5% CI limits were < 5% points. There was not evidence that treatment differences varied by subgroups, including by race or sex. For hip bone mineral density, estimated mean differences were +0.78% points (p=0.19) and -0.64% points (p=0.27), respectively. The observed median change in creatinine clearance was 4.9% in DOR+TAF/FTC, 7.4% in DOR+TDF/FTC, and 0.4% in INSTI+TAF/FTC.CONCLUSIONS: In people with HIV and obesity, switching from an INSTI+TAF/FTC regimen to doravirine/FTC with either TAF or TDF did not result in substantial weight change at one year, including among women and Blacks.