Effect of dolutegravir-based antiretroviral therapy transition on body mass index in adolescents living with HIV: secondary analysis of data from the ANRS 12225 Pediacam III cohort in Cameroon

AIDS Research and Therapy https://doi.org/10.1186/s12981-026-00888-z Article in Press Effect of dolutegravir-based antiretroviral therapy transition on body mass index in adolescents living with HIV: secondary analysis of data from the ANRS 12225 Pediacam III cohort in Cameroon Received: 23 October 2025 Accepted: 10 April 2026 Cite this article as: Noumsi T.S.J., Sandie A.B., Ateba Ndongo F. et al. Effect of dolutegravir-based antiretroviral therapy transition on body mass index in adolescents living with HIV: secondary analysis of data from the ANRS 12225 Pediacam III cohort in Cameroon. AIDS Res Ther (2026). https:// doi.org/10.1186/s12981-026-00888-z A S S Thierry Serge Joël Noumsi, Arsène Brunelle Sandie, Francis Ateba Ndongo, Suzie Tetang Ndiang, Georgette Guemkam, Verlaine Bolyse Mbouchong, Mireille Fossi, Ida Calixte Penda, Jules Brice Tchatchueng Mbougua, Albert Faye, Josiane Warszawski & Mathurin Cyrille Tejiokem IN E R P We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply. I T R E L C If this paper is publishing under a Transparent Peer Review model then Peer Review reports will publish with the final article. © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. ACCEPTED ARTICLEMANUSCRIPT IN PRESS Effect of dolutegravir-based antiretroviral therapy transition on body mass index in adolescents living with HIV: Secondary analysis of data from the ANRS 12225 Pediacam III cohort in Cameroon Thierry Serge Joël Noumsi1, Arsène Brunelle Sandie2, Francis Ateba Ndongo3, Suzie Tetang Ndiang4, Georgette Guemkam3, Verlaine Bolyse Mbouchong1, Mireille Fossi5, Ida Calixte Penda6, 7, Jules Brice Tchatchueng Mbougua1, Albert Faye8, 9, Josiane Warszawski10, 11, Mathurin Cyrille Tejiokem1, 10, * 1Centre S S E R P Pasteur du Cameroun, Epidemiology and Public Health Laboratory, IN Yaoundé, Cameroon, PO Box 1274, Yaoundé-Cameroon. E L C I T R A 2African Population and Health Research Center (APHRC), Nairobi, Kenya, P.O. Box 10787-00100 3Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé, Cameroun, P.O. Box 1936, Yaoundé, Cameroon. 4Centre Hospitalier d’Essos, Yaoundé, Cameroon 5Hôpital Laquinitinie, Douala, Cameroon 6Hôpital Gynéco-Obstétrique et Pédiatrique, Douala, Cameroun 7Faculté de Médecine et des Sciences Pharmaceutiques, Université de Douala, Douala, 8Université Paris Cité, Paris, France ACCEPTED ARTICLEMANUSCRIPT IN PRESS 9Hôpital Universitaire Robert Debré, Paris, France, 48, boulevard Sérurier 75019 Paris. 10CESP, INSERM, UVSQ, Université Paris-Saclay, 94807 Villejuif 11Hôpital de Bicêtre, Service de Santé Publique et d’Épidémiologie, Assistance Publique des Hôpitaux de Paris, Le Kremlin Bicêtre, France *Corresponding author at: Centre Pasteur du Cameroun, Epidemiology and Public Health Department, PO Box 1274, Yaoundé-Cameroon. +237 677 645 258, email E L C I T R A IN S S E R P Tel: ACCEPTED ARTICLEMANUSCRIPT IN PRESS Abstract Background: Dolutegravir (DTG) is widely used in people living with HIV, but its potential association with weight gain remains insufficiently documented in adolescents. This study assessed the effect of transitioning to a DTG-based regimen on body mass index (BMI) in adolescents living with HIV (ALHIV) in Cameroon. Methods: Data prospectively collected between 2020 and 2024 from the ANRS 12225-Pediacam III cohort were retrospectively analyzed. The analysis included 105 ALHIV who switched to DTG (HI-DTG), 18 ALHIV who S S E R P did not (HI-nDTG), and 180 HIV-uninfected adolescents born to HIV-positive mothers (HEU, n=79) or to HIV-negative mothers (HUU, n=101). Body IN mass index (BMI) trajectories and levels were compared across groups E L C I T R A using linear mixed-effects models, as well as before and after the DTG transition within the HI-DTG group. Results: The median age was 11.5 years (IQR:11.0–12.5), which significant differences between groups. Overall, 51.6% were female. The median follow-up on DTG was 2.6 years (IQR:2.0–3.2). BMI trajectories differed across groups (p = 0.045) after adjustment for sex, age, baseline BMI zscore, household income, and interaction terms. Compared with HI-nDTG as the reference group, the HI-DTG group showed a modest but significant greater annual increase in BMI (0.32 kg/m²/year; 95% CI: 0.03–0.62; p = 0.03), with no differences observed for HEU or HUU. Baseline BMI z-score, household income, and female sex were more strongly associated with BMI ACCEPTED ARTICLEMANUSCRIPT IN PRESS over time than DTG use. Within the HI-DTG group, a mean annual increase of 0.19 kg/m²/year was observed after switching to DTG. Conclusion: Switching to DTG was associated with an increase in BMI among ALHIV. These findings underscore the need for close metabolic monitoring to prevent long-term cardiometabolic complications. Keywords: HIV, dolutegravir, weight gain, body mass index, adolescents. E L C I T R A IN S S E R P ACCEPTED ARTICLEMANUSCRIPT IN PRESS Introduction In 2019, the World Health Organization (WHO) recommended the inclusion of dolutegravir (DTG) in first- and second-line combination antiretroviral therapy (cART) regimens (1). DTG offers several advantages over older antiretrovirals, including high efficacy, good tolerability, and a high genetic barrier to resistance (2,3). Due to its demonstrated superiority over Efavirenz-based regimen, and in alignment with international guidelines and emerging evidence, Cameroon, along with 82 other low- and middle-income countries rapidly adopted DTG in its national treatment guidelines in 2019 (4,5). S S E R P However, DTG has been associated with some adverse effects, most notably IN neuropsychiatric complaints, which were among the first reported (6). E L C I T R A Moreover, several studies have sugge (...truncated)