Common adverse effects of integrase strand transfer inhibitors (INSTIs) include which of the following?

• A. Weight gain
• B. Rash
• C. Nephrotoxicity
• D. Hypersensitivity

Answer: (A)

Weight gain is a recognized and common adverse effect of integrase strand transfer inhibitors, especially with regimens containing dolutegravir or bictegravir. Clinical experience and trials show patients often experience gradual increases in weight on INSTI-based therapy, a phenomenon that clinicians monitor because it can affect metabolic health and adherence. The mechanism isn’t completely defined, but likely involves metabolic changes that accompany viral suppression and immune recovery.

Rash can occur with antiretrovirals but isn’t as consistently observed with INSTIs as weight gain. Hypersensitivity reactions are classically linked to drugs like abacavir, not INSTIs. Nephrotoxicity is not a typical issue with INSTIs; while some may have a small rise in serum creatinine due to effects on renal tubular secretion, this doesn’t reflect true kidney injury.