This study will investigate changes in insulin resistance, lipid metabolism and endocrine profile in HIV-negative subjects exposed to dolutegravir (an antiretroviral drug used in HIV treatment) in order to investigate the role all these different factors may potentially have in weight gain recently reported in clinical cohorts.
A randomised, crossover study investigating the difference in changes in insulin sensitivity (determined by peripheral glucose uptake using a euglycaemic clamp) with the administration of dolutegravir (DTG) compared to no DTG for 28 days in HIV seronegative healthy volunteers. Participants will be randomised 1:1 to one of two arms: Group 1: * Dolutegravir 50 mg once daily for the first 28 days of the study. * No treatment for the last 44 days of the study. Group 2: * No treatment for the first 28 days of the study. * Dolutegravir 50 mg once daily for the last 28 days of the study (day 44-72). Research bloods, endocrine profiles, weight and urine samples will be collected at baseline, as well as day 28, 44, and 72 to enable comparative analyses. Participants will be closely monitored whilst taking the study medications. Participants will exit the study 72 days post-randomisation, with a follow-up call 28 days after exiting.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
16
50 mg once daily orally
Arnold Xhikola
London, United Kingdom
Change in Insulin Sensitivity in Participants From Baseline to End of Study Between Two Crossover Groups.
Change in insulin sensitivity will be determined by peripheral glucose uptake using a euglycaemic clamp.
Time frame: Baseline, day 28 and 72 for both groups.
Effect of Dolutegravir on Adipocytokines.
Fasting adiponectin levels in blood.
Time frame: Baseline, day 28 and 72 for both groups.
Effect of Dolutegravir on Pituitary Hormones
Cortisol
Time frame: Baseline, day 28 and 72 for both groups.
Effect of Dolutegravir on Changes in Indirect Calorimetry
Indirect calorimetry by ventilated hood expires gas analysis will be used to determine energy expenditure during the course of the clamp procedures.
Time frame: Baseline, day 28 and 72 for both groups.
Effect of Dolutegravir on Adipocytokines.
Fasting Leptin levels in blood.
Time frame: Baseline, day 28 & 72 for both groups.
Effect of Dolutegravir on Adipocytokines.
Fasting Ghrelin levels in blood.
Time frame: Baseline, day 28 & 72 for both groups.
Effect of Dolutegravir on Pituitary Hormones
Prolactin
Time frame: Baseline, day 28 and 72 for both groups.
Effect of Dolutegravir on Pituitary Hormones
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Luteinsing Hormone Level
Time frame: Baseline, day 28 and 72 for both groups.
Effect of Dolutegravir on Pituitary Hormones
Growth Hormone
Time frame: Baseline, day 28 and 72 for both groups.
Effect of Dolutegravir on Lipid Profile Including Lipid Fractions
Total Cholesterol
Time frame: Baseline, day 28 and 72 for both groups.
Effect of Dolutegravir on Lipid Profile Including Lipid Fractions
Triglycerides
Time frame: Baseline, day 28 and 72 for both groups.
Changes in Food Intake by Food Preference Questionnaire
Changes in food intake Food preference questionnaire for adolescents and adults (FPQ) 1- Scoring of Individual Items Each food item is rated on a 5-point Likert scale: 1. = Dislike a lot 2. = Dislike a little 3. = Neither like nor dislike 4. = Like a little 5. = Like a lot Responses marked as "Not applicable" are treated as missing and not included in scoring. Food Category Scores Items are grouped into six categories, each scored by averaging across the foods in that group: Vegetables (18 items) Fruits (7 items) Meat/Fish (12 items) Dairy (10 items) Snacks (9 items) Starches (6 items) The category score is the mean of item scores in that category (sum ÷ number of items). For both individual items and category scores: Minimum possible score = 1 ("Dislike a lot") Maximum possible score = 5 ("Like a lot") Direction of Scoring On the FPQ, higher scores reflect greater liking of the foods, Lower scores indicate less liking. 'scores on a scale'
Time frame: Baseline, day 28 and 72 for both groups.
Change in Sleep Parameters by Sleep Questionnaires
changes in sleep parameters by Pittsbrough Sleep Quality Index (PSQI) 1. Scoring Components The PSQI has 19 self-rated items, grouped into 7 component scores: Subjective sleep quality Sleep latency Sleep duration Habitual sleep efficiency Sleep disturbances Use of sleeping medication Daytime dysfunction Each component is scored from 0 to 3, where higher values indicate worse sleep in that domain. 2. Global Score The 7 component scores are summed to yield a global PSQI score ranging from 0 to 21. 0 = no difficulty / very good sleep quality 21 = severe difficulties / very poor sleep quality 3- Interpretation A global score \> 5 is commonly used as a cut-off to distinguish between "good sleepers" (≤5) and "poor sleepers" (\>5). 4- Direction of Scoring On the PSQI, higher scores indicate worse outcomes (poorer sleep quality). Lower scores indicate better sleep quality. Unit of Measue = Score on a scale
Time frame: Baseline, day 28 and 72 for both groups.