# ART-gerelateerde gewichtstoename en viscerale adipositeit verhogen cardiometabool risico

*geplaatst 2026-10-08 · Hartfalen · Current opinion in HIV and AIDS · doi 10.1097/COH.0000000000001069 · https://hartvaat.nl/2026/11/01/art-gerelateerde-gewichtstoename-en-viscerale-adipositeit-verhogen-cardiometaboo/*

Dit literatuuroverzicht beschrijft hoe bepaalde antiretrovirale therapieën (ART), zoals dolutegravir en tenofoviralafenamide, geassocieerd worden met gewichtstoename en veranderingen in vetweefsel bij mensen met HIV. Deze ART-gerelateerde viscerale adipositeit draagt bij aan een verhoogd risico op insulineresistentie, diabetes, MASLD en cardiovasculaire aandoeningen. Het overstappen van het ART-regime of het toevoegen van GLP-1-agonisten zoals semaglutide kan deze metabole verstoringen mogelijk omkeren. Voor de behandelend arts is het belangrijk om bij PWH op deze ART-regimes proactief cardiometabool risico en lichaamsgewicht te monitoren.

## English: Weight gain, adipose tissue remodeling and cardiometabolic disease in people with HIV.

This narrative review highlights how certain antiretroviral therapies (ART), particularly dolutegravir and tenofovir alafenamide, are associated with weight gain and adverse adipose tissue remodeling in people with HIV. Increased visceral adiposity driven by these regimens elevates the risk of insulin resistance, type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, and cardiovascular disease. Switching ART regimens or incorporating anti-obesity medications like semaglutide may help reverse these metabolic changes. Clinicians should proactively monitor cardiometabolic risk and weight in HIV patients on these specific ART protocols.

## Abstract (original, from the publication)

PURPOSE OF REVIEW: Weight gain and associated adipose tissue remodeling have been partly linked to HIV infection and to some current antiretroviral therapy (ART) regimens in ART-naive and ART-controlled people with HIV (PWH). This review addresses recent findings on adipose tissue distribution and remodeling in PWH, receiving dolutegravir, bictegravir and/or tenofovir alafenamide (TAF), highlighting how visceral adiposity contributes to cardiometabolic comorbidities. RECENT FINDINGS: Preclinical models exposed to dolutegravir, bictegravir, tenofovir disoproxil fumarate (TDF) and/or TAF demonstrate alterations in adipose tissue, including mitochondrial dysfunction, fibrosis, inhibited beiging, and insulin resistance. Transcriptomic studies of abdominal subcutaneous fat from ART-controlled PWH further revealed elevated inflammation, fibrosis and insulin resistance. Increased visceral adiposity raises the risk of cardiometabolic disorders such as insulin resistance and diabetes, metabolic-dysfunction-associated steatotic liver disease and cardiovascular diseases. Reversing weight gain linked to ART, by switching regimens or adding antiobesity medications like the GLP-1 receptor agonist semaglutide, has shown potential in reducing adipose tissue remodeling, visceral adiposity and cardiometabolic risk factors. SUMMARY: Weight gain and increased visceral adiposity partly driven by some ARTs are associated with higher cardiometabolic risk. HIV and ART can either activate or suppress the fat beiging/browning phenotype. Reversing weight gain and visceral adiposity in at-risk PWH is a critical clinical goal.

Auteurs: Jennifer Gorwood, Jacqueline Capeau, Véronique Béréziat, Claire Lagathu

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Bron: Current opinion in HIV and AIDS, https://doi.org/10.1097/COH.0000000000001069. Bijgewerkt 2026-10-02T00:56:54Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.