---
title: "Weight gain, adipose tissue remodeling and cardiometabolic risk in people with HIV"
id: "pubmed-42817202"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42817202"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42817202/"
doi: "10.1097/COH.0000000000001069"
published_at: "2026-10-01T09:57:29.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Weight gain, adipose tissue remodeling and cardiometabolic risk in people with HIV
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42817202
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42817202/)
- **DOI:** [10.1097/COH.0000000000001069](https://doi.org/10.1097%2FCOH.0000000000001069)
- **Published At:** 2026-10-01T09:57:29.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Weight gain and changes in fat distribution in people with HIV (PWH) have been partly attributed to HIV infection itself and to some antiretroviral therapy (**ART**) regimens, including agents such as **dolutegravir**, **bictegravir** and tenofovir alafenamide (**TAF**). - Preclinical studies of exposures to dolutegravir, bictegravir, tenofovir disoproxil fumarate (TDF) and TAF report **adipose tissue** alterations: mitochondrial dysfunction, increased fibrosis, inhibited beiging/browning, and insulin resistance. - Transcriptomic analyses of abdominal subcutaneous fat from ART-controlled PWH show signatures of elevated inflammation, fibrosis and insulin resistance in adipose tissue. - Increased **visceral adiposity** in PWH is linked to higher risk of cardiometabolic disorders, including insulin resistance and diabetes, metabolic-dysfunction-associated steatotic liver disease, and cardiovascular disease. - Interventions to reverse ART-associated weight gain—such as switching ART regimens or adding antiobesity medications like the GLP-1 receptor agonist **semaglutide**—have shown potential to reduce adipose tissue remodeling, visceral fat, and cardiometabolic risk factors. - HIV and ART can variably affect the fat beiging/browning phenotype, either activating or suppressing it, which may influence metabolic outcomes. - The review emphasizes that reducing weight gain and visceral adiposity in at-risk PWH is a key clinical objective to mitigate cardiometabolic risk. - Keywords and mechanistic themes highlighted include adipogenesis, fat beiging, inflammation, insulin resistance and mitochondrial dysfunction.
## Clinical Analysis & Structured Key Points
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Epub 2026 Oct 1. # Weight gain, adipose tissue remodeling and cardiometabolic disease in people with HIV [Jennifer Gorwood](https://pubmed.ncbi.nlm.nih.gov/?term=Gorwood+J&cauthor_id=42817202)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42817202/#full-view-affiliation-1 "Sorbonne Université - Inserm UMR_S938, Centre de Recherche Saint-Antoine, Institut Hospitalo - Universitaire de Cardio-Métabolisme et Nutrition \(ICAN\), Paris, France."), [Jacqueline Capeau](https://pubmed.ncbi.nlm.nih.gov/?term=Capeau+J&cauthor_id=42817202), [Véronique Béréziat](https://pubmed.ncbi.nlm.nih.gov/?term=B%C3%A9r%C3%A9ziat+V&cauthor_id=42817202), [Claire Lagathu](https://pubmed.ncbi.nlm.nih.gov/?term=Lagathu+C&cauthor_id=42817202) Affiliations Expand ### Affiliation * 1 Sorbonne Université - Inserm UMR_S938, Centre de Recherche Saint-Antoine, Institut Hospitalo - Universitaire de Cardio-Métabolisme et Nutrition (ICAN), Paris, France. * PMID: **42817202** * DOI: [ 10.1097/COH.0000000000001069 ](https://doi.org/10.1097/coh.0000000000001069) Item in Clipboard Review # Weight gain, adipose tissue remodeling and cardiometabolic disease in people with HIV Jennifer Gorwood et al. Curr Opin HIV AIDS. 2026. Show details Display options Display options Format Abstract PubMed PMID Curr Opin HIV AIDS Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Curr+Opin+HIV+AIDS%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Curr+Opin+HIV+AIDS%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) . 2026 Nov 1;21(6):480-487. doi: 10.1097/COH.0000000000001069. Epub 2026 Oct 1. ### Authors [Jennifer Gorwood](https://pubmed.ncbi.nlm.nih.gov/?term=Gorwood+J&cauthor_id=42817202)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42817202/#short-view-affiliation-1 "Sorbonne Université - Inserm UMR_S938, Centre de Recherche Saint-Antoine, Institut Hospitalo - Universitaire de Cardio-Métabolisme et Nutrition \(ICAN\), Paris, France."), [Jacqueline Capeau](https://pubmed.ncbi.nlm.nih.gov/?term=Capeau+J&cauthor_id=42817202), [Véronique Béréziat](https://pubmed.ncbi.nlm.nih.gov/?term=B%C3%A9r%C3%A9ziat+V&cauthor_id=42817202), [Claire Lagathu](https://pubmed.ncbi.nlm.nih.gov/?term=Lagathu+C&cauthor_id=42817202) ### Affiliation * 1 Sorbonne Université - Inserm UMR_S938, Centre de Recherche Saint-Antoine, Institut Hospitalo - Universitaire de Cardio-Métabolisme et Nutrition (ICAN), Paris, France. * PMID: **42817202** * DOI: [ 10.1097/COH.0000000000001069 ](https://doi.org/10.1097/coh.0000000000001069) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **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. **Keywords:** adipogenesis; fat beiging; inflammation; insulin resistance; mitochondrial dysfunction. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## References 1. 1. Cani PD, Van Hul M. Gut microbiota in overweight and obesity: crosstalk with adipose tissue. Nat Rev Gastroenterol Hepatol 2024; 21:164–183. 2. 1. Becher T, Palanisamy S, Kramer DJ, et al. Brown adipose tissue is associated with cardiometabolic health. Nat Med 2021; 27:58–65. 3. 1. Sax PE, Erlandson KM, Lake JE, et al. Weight gain following initiation of antiretroviral therapy: risk factors in randomized comparative clinical trials. Clin Infect Dis 2020; 71:1379–1389. 4. 1. Koethe JR, Lagathu C, Lake JE, et al. HIV and antiretroviral therapy-related fat alterations. Nat Rev Dis Primers 2020; 6:48. 5. 1. Capeau J, Lagathu C, Bereziat V, Feve B. Recent data on adipose tissue, insulin resistance, diabetes and dyslipidaemia in antiretroviral therapy controlled HIV-infected persons. Curr Opin HIV AIDS 2021; 16:141–147. Show all 43 references ## Publication types * Review Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Review%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Review) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) ## MeSH terms * Adipose Tissue* / pathology Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adipose+Tissue%2Fpathology%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adipose+Tissue) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) * Anti-HIV Agents* / adverse effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-HIV+Agents%2Fadverse+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Anti-HIV+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) * Anti-HIV Agents* / therapeutic use Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-HIV+Agents%2Ftherapeutic+use%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Anti-HIV+Agents) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) * Cardiovascular Diseases* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cardiovascular+Diseases%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cardiovascular+Diseases) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) * HIV Infections* / complications Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22HIV+Infections%2Fcomplications%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=HIV+Infections) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) * HIV Infections* / drug therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22HIV+Infections%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=HIV+Infections) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) * Metabolic Diseases* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Metabolic+Diseases%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Metabolic+Diseases) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) * Weight Gain* / drug effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Weight+Gain%2Fdrug+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Weight+Gain) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) ## Substances * Anti-HIV Agents Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anti-HIV+Agents%22%5Bnm%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=%22Anti-HIV+Agents%22) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42817202/) [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To** * [Clipboard](https://pubmed.ncbi.nlm.nih.gov/42817202/) * [Email](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42817202%2F%23open-email-panel) * [Save](https://pubmed.ncbi.nlm.nih.gov/42817202/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42817202%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42817202%2F%23open-collections-panel) * [Citation Manager](https://pubmed.ncbi.nlm.nih.gov/42817202/) [x] NCBI Literature Resources [MeSH](https://www.ncbi.nlm.nih.gov/mesh/) [PMC](https://www.ncbi.nlm.nih.gov/pmc/) [Bookshelf](https://www.ncbi.nlm.nih.gov/books) [Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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