Mean time from baseline to weight/BMI assessments was 276+ 79 days. At this time point, mean weight gain was 3kg (P= 0.009) and mean BMI increase was 1kg/m2 (P= 0.002)(Fig. 1). We observed, for 20% of the patients, a more than 10% weight increase compared with baseline, whereas a 4–10% weight increase was observed for 27% of the patients. In addition, during follow-up, in 13% of the patients, BMI increased from class II to class III, and, in 9% of the patients with class III, BMI increased toward class IV. We further found that mean increases in BMI and weight were significant for women, whereas they only showed a tendency toward significancy for men. Finally, these increases were particularly significant for women receiving abacavir/lamivudine and dolutegravir, in whom weight increased from 57 to 62 kg (P= 0.009)(Fig. 1a) and BMI increased from 22 to 24 kg/m2 (P= 0.01)(Fig. 1b).

A recent study conducted in 41 149 HIV-infected patients from the D: A: D cohort showed that a high level of BMI may be associated with serious non-AIDS events [2]. In addition, body fat changes can be deleterious to selfperception and HAARTadherence [3]. Gains in central fat in HIV-positive patients were strongly associated with protease inhibitors of earlier generation. However, McComseyet al.[4] showed recently, in a large randomized ART-initiation trial including 328 patients, that central and peripheral fat changes did not differ after 96 weeks of treatment containing either two boosted protease inhibitors (including darunavir and atazanavir) or the integrase strand transfer inhibitor (INSTI) raltegravir (+ 1 kg/m2 in 3.8–4.7% of the patients). There are, to our knowledge, no data on the effect of other INSTIs on body composition. Nevertheless, an in-vitro study showed that, in contrast with raltegravir, elvitegravir altered adipocytes differentiation and function, although less than efavirenz [5].