Combined antiretroviral therapy with low- or normal-protein, high-calorie diets appears to induce significant deleterious electrocardiographic changes in a rodent model.

Chege BM, Mwangi PW, Githinji CG, Bukachi F

Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas17 Apr 2026

PMID42018810PMCIDPMC13089955DOI10.1590/1414-431x2026e14744PepBankPUB-42018810

Summary

The introduction of combination antiretroviral therapy (cART) has significantly reduced AIDS-related morbidity and mortality. However, the prevalence of age-associated comorbidities, particularly cardiovascular diseases (CVD), has increased, becoming a leading cause of mortality in people living with HIV. This study investigated the interaction between cART regimens and dietary composition on electrocardiographic (ECG) parameters and myocardial histopathology. A total of 120 weanling Sprague Dawley rats were allocated to one of three diets for 15 weeks: normal chow, a calorie-dense low protein (CDLP) diet, or a calorie-dense normal protein (CDNP) diet. Each dietary group was then subdivided into four treatment groups for a further 9 weeks: a standard group (normal saline), Test group 1 (dolutegravir (DTG) plus tesamorelin), Test group 2 (DTG only), and a positive control (classical cART regimen). ECG recordings and histological assessments were performed at week 24. Significant intergroup variations in ECG indices were observed, including Q, R, S, and T wave amplitudes, PR interval, QRS duration, ST height, and QTc (all P<0.0001). Myocardial fibrosis (P<0.0001) was evident in animals from the TG2 (DTG only) and PC (classical regimen) groups maintained on CDLP and CDNP diets. These findings demonstrated that CDLP and CDNP diets, combined with DTG-based or classical cART regimens, exerted deleterious cardiac effects, promoting myocardial fibrosis that disrupts normal electrical conduction and may predispose to arrhythmogenesis. Tesamorelin prevented these effects, implicating growth hormone pathway dysfunction in the underlying pathology.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study2

2 results from studies that gave the peptide. No result from this study comes from people.

01AnimalAnimal study (in vivo)Safety outcome
In rats on calorie-dense diets given DTG-based or classical cART, adding tesamorelin to DTG prevented the deleterious ECG changes.
In plain wordsIn rats on calorie-dense diets given HIV drugs, tesamorelin prevented harmful heart tracing changes seen with the drugs alone.
Peptide
Tesamorelin
Outcome
DecreaseElectrocardiographic changes
Study
Sprague Dawley ratn: not reported in source
Rats on normal, calorie-dense low-protein or calorie-dense normal-protein diets given cART
Comparator
DTG only and classical cART groups
Outcome group
Heart function · Cardiovascular
Studied dose
Dose not stated · 9 weeksAs given in this study (Sprague Dawley rat).
Source sentences
Summary
Tesamorelin prevented these effects, implicating growth hormone pathway dysfunction in the underlying pathology.
3 context sentences(design, population, supporting numbers)
Summary · context
Significant intergroup variations in ECG indices were observed, including Q, R, S, and T wave amplitudes, PR interval, QRS duration, ST height, and QTc (all P<0.0001).
Summary · context
A total of 120 weanling Sprague Dawley rats were allocated to one of three diets for 15 weeks: normal chow, a calorie-dense low protein (CDLP) diet, or a calorie-dense normal protein (CDNP) diet.
Summary · context
Each dietary group was then subdivided into four treatment groups for a further 9 weeks: a standard group (normal saline), Test group 1 (dolutegravir (DTG) plus tesamorelin), Test group 2 (DTG only), and a positive control (classical cART regimen).
Show in the study text Report a problemFND-4201881001
02AnimalAnimal study (in vivo)Safety outcome
In rats on calorie-dense diets, myocardial fibrosis appeared in the DTG-only and classical cART groups, and tesamorelin prevented these effects.
In plain wordsIn rats on calorie-dense diets, tesamorelin prevented heart scarring seen with the HIV drug regimens given without it.
Peptide
Tesamorelin
Outcome
DecreaseMyocardial fibrosis
Study
Sprague Dawley ratn: not reported in source
Rats on normal, calorie-dense low-protein or calorie-dense normal-protein diets given cART
Comparator
DTG only and classical cART groups
Outcome group
Heart function · Cardiovascular
Studied dose
Dose not stated · 9 weeksAs given in this study (Sprague Dawley rat).
Source sentences
Summary
Tesamorelin prevented these effects, implicating growth hormone pathway dysfunction in the underlying pathology.
3 context sentences(design, population, supporting numbers)
Summary · context
Myocardial fibrosis (P<0.0001) was evident in animals from the TG2 (DTG only) and PC (classical regimen) groups maintained on CDLP and CDNP diets.
Summary · context
A total of 120 weanling Sprague Dawley rats were allocated to one of three diets for 15 weeks: normal chow, a calorie-dense low protein (CDLP) diet, or a calorie-dense normal protein (CDNP) diet.
Summary · context
Each dietary group was then subdivided into four treatment groups for a further 9 weeks: a standard group (normal saline), Test group 1 (dolutegravir (DTG) plus tesamorelin), Test group 2 (DTG only), and a positive control (classical cART regimen).
Show in the study text Report a problemFND-4201881002

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Version history

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Version 2Current
9 Oct 2026, 19:08 UTC
Study results updated
Version 1
9 Oct 2026, 03:13 UTC
First added · source update from Europe PMC

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