The AIDS Clinical Trials Group (ACTG) presented data from the REPRIEVE study at the 2025 Conference on Retroviruses and Opportunistic Infections. The study found that switching to an integrase inhibitor-based antiretroviral regimen in people living with HIV increased the risk of weight gain, diabetes, hypertension, and metabolic syndrome over five years, compared to those who didn’t switch. However, the switch did not increase the risk of major adverse cardiovascular events like heart attacks or strokes.
This research is crucial for HIV treatment strategies. While integrase inhibitors are effective antiretroviral drugs, the observed increased risk of metabolic complications necessitates a more comprehensive approach to patient care. Clinicians must now balance the antiviral benefits of these drugs with the potential for long-term metabolic issues. This highlights the need for personalized medicine and consistent monitoring of patients on integrase inhibitor regimens.
The REPRIEVE study involved 2,708 participants who switched to an integrase inhibitor-containing regimen, most of which included dolutegravir. The study revealed statistically significant increases in the risks of obesity, diabetes, hypertension, and metabolic syndrome in those who switched. Though no increased risk of MACE was observed in the five-year follow-up period, continued monitoring is necessary to understand the long-term cardiovascular implications.
This data reinforces the need for further research to investigate the mechanisms behind these metabolic changes and to explore strategies to mitigate these risks. Long-term studies are crucial to fully understand the cardiovascular impact of integrase inhibitors and to guide clinical decisions regarding their use. This information emphasizes the evolving nature of HIV treatment and the ongoing need for proactive patient management strategies.
Jon Napitupulu is Director of Media Relations at The Clinical Trial Vanguard. Jon, a computer data scientist, focuses on the latest clinical trial industry news and trends.
