When people started highly effective antiretroviral treatment, they gained weight. This is called a return to health effect of treatment and is still seen today in people with very advanced HIV who lost weight before starting treatment.

Which ARVs cause weight gain?

All antiretroviral drug classes were associated with weight gain but people receiving an integrase inhibitor (elvitegravir, dolutegravir or bictegravir) gained significantly more weight (+3.24kg) than people taking either an NNRTI (efavirenz or rilpivirine; +1.93kg) or a protease inhibitor (atazanavir/ritonavir; +1.6kg

What happens when one stops taking ARVs?

ARVs are a lifelong commitment. If you stop taking them, you are likely to get sicker than before. During the period that you stop taking your medication, you give HIV a chance to become resistant to the ARV drug combination you are taking and that regimen may not work for you again.