Association of Integrase Strand Transfer Inhibitor-Based Antiretroviral Regimens With Serum Uric Acid Trajectories and Hyperuricemia Probability: A Real-World Longitudinal Cohort Study

Research on serum uric acid (UA) trajectories in HIV/AIDS patients receiving integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) remains limited. This retrospective cohort study included 212 patients categorized by ART exposure into four groups: continuous non-INSTI, non-INSTI to INSTI switch, continuous INSTI, and INSTI to non-INSTI switch groups. After 1:1 matching, linear mixed-effects models were used to assess longitudinal UA changes and hyperuricemia (HUA) probability. Baseline UA consistently predicted UA trajectories. A significant three-way interaction (regimen × time × baseline UA) was observed only in the continuous non-INSTI versus non-INSTI-to-INSTI switch comparison, indicating that in the group switching from non-INSTI-to-INSTI, the patients with high baseline UA presented a more pronounced decrease in UA levels than patients with normal baseline UA. Baseline UA was also correlated with HUA probability during follow-up. These findings indicate that baseline UA is an important predictor of long-term UA patterns and longitudinal probability of HUA during follow-up, whereas the INSTI-associated changes in UA trajectory are preliminary observations that require further validation.