Prevalence of obesity and cardiovascular risk in patients with HIV/AIDS in Porto Alegre, Brazil

Abstract

Objective: The aim of this study was to discover the prevalence of overweight, obesity and cardiovascular risk in our HIV/AIDS outpatients according to sex, antiretroviral therapy and other variables. Subjects and methods: Patients underwent an anthropometric assessment. Body mass index and waist circumference were used to classify their nutritional status and their cardiovascular risk. Results: The majority of the 345 patients (58.8%) were males. Obesity was detected in 8.3% of them; 34.2% were overweight, and 5.2% malnourished. Near half of them (51.3%) had some cardiovascular risk, with increased risk in 24.6% of them, and substantially increased risk in 26.7% of them. Conclusions: Overweight and obesity were highly prevalent. Women were more frequently obese (OR = 3.53; IC 95%, 1.47 < OR < 8.69), and their cardiovascular risk was often higher (OR = 6.97; IC 95%, 4.16 < OR < 11.76). The prevalence of obesity and cardiovascular risk did not change according to antiretroviral therapy or other variables. Arq Bras Endocrinol Metab. 2012;56(2):137-41 Keywords Overweight; obesity; body mass index; HIV; acquired immunodeficiency syndrome RESUMO Objetivo: Conhecer a prevalência de sobrepeso, obesidade e risco cardiovascular em nossos pacientes ambulatoriais com HIV/AIDS de acordo com o sexo, tratamento antirretroviral e outras variáveis. Sujeitos e métodos: Os pacientes foram submetidos à avaliação antropométri-ca. O índice de massa corporal e a medida da circunferência da cintura foram utilizados para classificar o estado nutricional e o risco cardiovascular. Resultados: A maior parte dos 345 pacientes (58,8%) era do sexo masculino. A obesidade foi detectada em 8,3% deles; 34,2% tinham sobrepeso e 5,2%, desnutrição. Quase a metade (51,3%) apresentou algum risco cardiovascular, com risco elevado em 24,6% e muito elevado em 26,7%. Conclusões: O sobrepeso e a obesidade têm elevada prevalência. As mulheres são mais frequentemente obesas (OR = 3,53; IC 95%, 1,47 < OR < 8,69) e seu risco cardiovascular é frequentemente mais alto (OR = 6,97; IC 95%, 4,16 < OR < 11,76). A prevalência de obesidade e de risco cardiovascular não se alterou conforme o tratamento antirretroviral ou outras variáveis. Arq Bras Endocrinol Metab. 2012;56(2):137-41 Descritores

Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy

“…Despite the introduction of highly active antiretroviral therapy, these characteristics have also been reported by other studies 2,3,19 . The mean BMI in the present investigation differed from that reported by Silva et al 20 in 2010, who found a mean BMI of 24.4kg/m² (SD 4.3kg/m²) in patients receiving HAART in the City of Sao Paulo (Brazil), and that reported by Kroll et al 21 , who found that the prevalence of excess weight (overweight or obesity) was higher than the prevalence of malnutrition among HIV/AIDS patients 21 . This difference may be explained by the patient profi le, as the subjects in the studies cited were in outpatient follow-up, whereas those in the present study were hospitalized and therefore in worse clinical condition.…”

Overweight and abdominal obesity in adults living with HIV/AIDS

“…8 However, this association was not found by other researchers. 5,6,18 In the studies available so far, as well as in this study, no association was found between overweight, abdominal obesity and use of regimens containing PI. 5,6,18,29 An association with HAART, including specific regimes, is recognized with respect to lipodystrophy 30 but it is not described in the literature related to excess weight.…”

“…6,8,17,18 With the use of new antiretroviral drug therapies and the consequent increase in survival of patients, low body weight is no longer frequent, giving way to overweight and obesity. 7,8,19 Thus, the current prevalence of overweight in PLWHA reflects the current trends of the general population, affecting around 49.0% of Brazilian adults.…”

Factors associated with undernourishment among people 20 years old or over with HIV/AIDS, attending public health services in the São Paulo municipality, Brazil

“…Other Brazilian studies present prevalences ranging from 1.5% to 5.9% among men, and 3.7% to 9.8% among women 15,16,17,23 . In discordance, this study found no difference in the prevalence of undernourishment according to sex and age.…”

“…The complexity of HIV infection and its consequences reinforce the need of health-related actions to maintain the nutritional status of this group of patients. As the subjects of most Brazilian studies on this matter are patients of one single clinic, 13,14,17,18,19,20,21 and few include a higher number of clinics connected to a health care network 15,16,22,23 , the investigations on the nutritional status of HIV/ AIDS individuals, particularly those focusing on undernourishment, in a sample of patients attended in a public healthcare network with facilities broadly distributed over a geographic area, such as the one of the city of São Paulo, Brazil, may contribute for the understanding of this phenomenon.…”