Associations Between At-Risk Alcohol Use, Substance Use, and Smoking with Lipohypertrophy and Lipoatrophy Among Patients Living with HIV

Noorhasan, Marisela; Drozd, Daniel R.; Grünfeld, Carl; Merrill, Joseph O.; Burkholder, Greer A.; Mugavero, Michael J.; Willig, James H.; Willig, Amanda L.; Cropsey, Karen L.; Mayer, Kenneth H.; Blashill, Aaron J.; Mimiaga, Matthew J.; McCaul, Mary E.; Hutton, Heidi E.; Chander, Geetanjali; Mathews, W. Christopher; Napravnik, Sonia; Eron, Joseph J.; Christopoulos, Katerina; Fredericksen, Rob J.; Nance, Robin M.; Delaney, Joseph A.; Crane, Paul K.; Saag, Michael S.; Kitahata, Mari M.; Crane, Heidi M.

doi:10.1089/aid.2015.0357

Cited by 6 publications

(5 citation statements)

References 54 publications

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“…In this study, the prevalence of central obesity was 71.7% (95% CI: 67%–76.4%). This finding is higher than those in studies conducted elsewhere, for instance, 4% in the United States [ 10 ], 12.6% in Tanzania [ 11 ], 36.5% in Malaysia [ 12 ], and 45.7% in Brazil [ 13 ]. This discrepancy may be due to the type used to measure central obesity and sample size variation, in which the current study utilized a large sample size and WHR, which early detected central obesity among HIV-infected population.…”

Section: Discussioncontrasting

confidence: 58%

“…HIV-infected patients had more abdominal visceral fat than extremity fat and demonstrated a higher waist-to-hip ratio (WHR) compared to the control population [ 7 – 9 ]. Similar to the general population, the prevalence of central obesity (the localized accumulation of adipose tissue in the abdomen irrespective of proportion to total body fat) is increasing among HIV-infected persons, for instance, 4% in the United States [ 10 ], 12.6% in Tanzania [ 11 ], 36.5% in Malaysia [ 12 ], and 45.7% in Brazil [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Different factors were implicated for central obesity such as female gender [ 14 ], advanced age (age of 40–49 years and ≥50 years) [ 10 , 12 , 14 ], higher CD4+ lymphocyte count (>350 cells/mm³) [ 10 , 14 ], higher fasting plasma glucose [ 12 ], and higher body mass index (BMI) [ 12 ]. Evidence also showed that, for every increase of 10 g of lipid intake, the odds of central obesity increased 1.28 times.…”

Section: Introductionmentioning

confidence: 99%

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Central Obesity and Associated Factors among Adult Patients on Antiretroviral Therapy (ART) in Armed Force Comprehensive and Specialized Hospital, Addis Ababa, Ethiopia

Kemal¹,

Ahmed

Teshome

et al. 2021

Journal of Obesity

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Background. Similar to the general population, the prevalence of central obesity is increasing among HIV-infected persons. There are little data on the burden of abdominal obesity using the waist-to-hip ratio measurement in HIV-infected patients in resource-limited settings, including Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of central obesity among HIV patients taking ART in an armed force comprehensive and specialized hospital, Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted from March to April 2018. A systematic sampling method was used to select 353 study participants. Pretested World Health Organization stepwise questionnaire, document review, and anthropometric and biochemical measurements were used to collect data on different variables under the study. The collected data were entered into EpiData version 3 and analyzed by SPSS version 21. An adjusted odds ratio with 95% CI was considered to declare a statistically significant association. Results. The prevalence of central obesity in this study was 71.7% (95% CI: 67%–76.4%). Besides, the odds of central obesity were associated with being female (AOR: 85.6; 95% CI: 20.09, 364.6), among merchants (AOR: 18.8; 95% CI: 1.39, 255.7), CD4 count <200 cells/mm3 (AOR: 0.03; 95% CI: 0.007, 0.160), among respondents taking AZT + 3TC + EFV-based ART regimen (AOR: 8.73; 95% CI: 1.33, 57.17), ABC + 3TC + ATV/r-based regimen (AOR: 0.18; 95% CI: 0.03, 0.94), increased BMI (AOR: 3.50; 95% CI: 1.36, 3.89), and abnormal blood pressure (AOR: 2.53; 95%: 1.13, 5.67). Conclusion. It is possible to conclude that central obesity is a huge public health problem among the HIV-infected population in the study area. Being female, increased BMI, low CD4 count, AZT + 3TC + EFV, ABC + 3TC + ATV/r-based regimen, and abnormal blood pressure were associated with central obesity. Therefore, adequate attention must be paid to primary and secondary control of these factors to reduce the prevalence of abdominal obesity among HIV-infected patients.

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Central Obesity and Associated Factors among Adult Patients on Antiretroviral Therapy (ART) in Armed Force Comprehensive and Specialized Hospital, Addis Ababa, Ethiopia

Kemal¹,

Ahmed

Teshome

et al. 2021

Journal of Obesity

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“…Of all studies within this section, 2 studies investigated symptom mitigation (see online suppl. material) as the primary outcome, 4 studies investigated the effect on adherence to antiretroviral therapy, 2 studies investigated the effect on viral suppression, 5 studies investigated safety outcomes, and 12 studies investigated other outcomes or used a cross-sectional design [159][160][161][162][163][164][165][166][167][168][169][170]. Among the 2 studies that investigated symptom mitigation, one indicated an improvement [120] and one was inconclusive [115].…”

Section: Human Immunodeficiency Virus/aidsmentioning

confidence: 99%

A Mapping Literature Review of Medical Cannabis Clinical Outcomes and Quality of Evidence in Approved Conditions in the USA from 2016 to 2019

Jugl

Okpeku

Costales

et al. 2021

Med Cannabis Cannabinoids

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In 2017, a National Academies of Sciences, Engineering, and Medicine (NASEM) report comprehensively evaluated the body of evidence regarding cannabis health effects through the year 2016. The objectives of this study are to identify and map the most recently (2016–2019) published literature across approved conditions for medical cannabis and to evaluate the quality of identified recent systematic reviews, published following the NASEM report. Following the literature search from 5 databases and consultation with experts, 11 conditions were identified for evidence compilation and evaluation: amyotrophic lateral sclerosis, autism, cancer, chronic noncancer pain, Crohn’s disease, epilepsy, glaucoma, human immunodeficiency virus/AIDS, multiple sclerosis (MS), Parkinson’s disease, and posttraumatic stress disorder. A total of 198 studies were included after screening for condition-specific relevance and after imposing the following exclusion criteria: preclinical focus, non-English language, abstracts only, editorials/commentary, case studies/series, and non-U.S. study setting. Data extracted from studies included: study design type, outcome definition, intervention definition, sample size, study setting, and reported effect size. Few completed randomized controlled trials (RCTs) were identified. Studies classified as systematic reviews were graded using the Assessing the Methodological Quality of Systematic Reviews-2 tool to evaluate the quality of evidence. Few high-quality systematic reviews were available for most conditions, with the exceptions of MS (9 of 9 graded moderate/high quality; evidence for 2/9 indicating cannabis improved outcomes; evidence for 7/9 indicating cannabis inconclusive), epilepsy (3 of 4 graded moderate/high quality; 3 indicating cannabis improved outcomes; 1 indicating cannabis inconclusive), and chronic noncancer pain (12 of 13 graded moderate/high quality; evidence for 7/13 indicating cannabis improved outcomes; evidence from 6/7 indicating cannabis inconclusive). Among RCTs, we identified few studies of substantial rigor and quality to contribute to the evidence base. However, there are some conditions for which significant evidence suggests that select dosage forms and routes of administration likely have favorable risk-benefit ratios (i.e., epilepsy and chronic noncancer pain). The body of evidence for medical cannabis requires more rigorous evaluation before consideration as a treatment option for many conditions, and evidence necessary to inform policy and treatment guidelines is currently insufficient for many conditions.

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“…Studies have typically not evaluated the independent contributions of each substance used by PLWH let alone the frequency of use by drug. This is an important gap given differences in impact of individual substances on outcomes such as adherence and depression among PLWH [4,[15][16][17].…”

mentioning

confidence: 99%

Impact of Abstinence and of Reducing Illicit Drug Use Without Abstinence on Human Immunodeficiency Virus Viral Load

Nance

Trejo

Whitney

et al. 2019

Clinical Infectious Diseases

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Background Substance use is common among people living with human immunodeficiency virus (PLWH) and a barrier to achieving viral suppression. Among PLWH who report illicit drug use, we evaluated associations between HIV viral load (VL) and reduced use of illicit opioids, methamphetamine/crystal, cocaine/crack, and marijuana, regardless of whether or not abstinence was achieved. Methods This was a longitudinal cohort study of PLWH from 7 HIV clinics or 4 clinical studies. We used joint longitudinal and survival models to examine the impact of decreasing drug use and of abstinence for each drug on viral suppression. We repeated analyses using linear mixed models to examine associations between change in frequency of drug use and VL. Results The number of PLWH who were using each drug at baseline ranged from n = 568 (illicit opioids) to n = 4272 (marijuana). Abstinence was associated with higher odds of viral suppression (odds ratio [OR], 1.4–2.2) and lower relative VL (ranging from 21% to 42% by drug) for all 4 drug categories. Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with VL suppression (OR, 2.2, 1.6, respectively). Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with lower relative VL (47%, 38%, respectively). Conclusions Abstinence was associated with viral suppression. In addition, reducing use of illicit opioids or methamphetamine/crystal, even without abstinence, was also associated with viral suppression. Our findings highlight the impact of reducing substance use, even when abstinence is not achieved, and the potential benefits of medications, behavioral interventions, and harm-reduction interventions.

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Associations Between At-Risk Alcohol Use, Substance Use, and Smoking with Lipohypertrophy and Lipoatrophy Among Patients Living with HIV

Cited by 6 publications

References 54 publications

Central Obesity and Associated Factors among Adult Patients on Antiretroviral Therapy (ART) in Armed Force Comprehensive and Specialized Hospital, Addis Ababa, Ethiopia

Central Obesity and Associated Factors among Adult Patients on Antiretroviral Therapy (ART) in Armed Force Comprehensive and Specialized Hospital, Addis Ababa, Ethiopia

A Mapping Literature Review of Medical Cannabis Clinical Outcomes and Quality of Evidence in Approved Conditions in the USA from 2016 to 2019

Impact of Abstinence and of Reducing Illicit Drug Use Without Abstinence on Human Immunodeficiency Virus Viral Load

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