Changes in body mass index, weight, and waist-to-hip ratio over five years in HIV-positive individuals in the HIV Heart Aging Study compared to the general population

Abstract

Purpose Overweight and obesity have increased in people living with HIV (PLH). Our study evaluated weight, body-mass-index (BMI), and waist-to-hip ratio (WHR) change over 5 years of follow-up in PLH compared to the general population. Methods HIV-positive participants in the HIV Heart Aging (HIVH) study were matched 1:2 by age and sex with HIV-negative controls of the population-based Heinz Nixdorf Recall (HNR) study. Both studies were recruited in the German Ruhr area. The association between HIV and weight, BMI, and WHR changes was examined using linear regression. Regression models were adjusted for parameters potentially affecting weight gain. Results The matched HIVH and HNR participants (N = 585 and N = 1170, respectively; 14.7% females) had a mean age of 55 years at baseline. Despite the lower baseline weight (− 6 kg, 95% CI − 7.46 to − 4.59), the linear regression showed greater absolute and relative weight and BMI increases after 5 years in HIVH compared to HNR. Adjusting the linear regression models for smoking amplified that HIVH had a higher absolute and relative weight difference of 0.7 kg or ~ 1% compared to HNR after 5 years (95% Cl 0.1 to 1.3 and 0.2 to 1.6, respectively). Adjusting for HDL, LDL, systolic blood pressure, and diabetes mellitus did not affect the results. Conclusions PLH had lower weight than the general population at baseline and after 5 years, but experienced greater increases in body weight after 5 years. WHR change after 5 years was lower in PLH compared to the general population, despite a higher WHR at baseline.

Trends in body mass index in the pre-dolutegravir period in South Africa

“…This observation aligns with the findings of other observational studies, affirming a sustained increase in BMI over time in patients, regardless of their HIV status. 17 , 18 , 19 …”

“…This observation aligns with the findings of other observational studies, affirming a sustained increase in BMI over time in patients, regardless of their HIV status. 17,18,19 There is ample evidence that PLWH starting INSTI gain significantly more weight compared to PLWH using a firstline ART regimen without INSTI. 10,20,21,22 However, most studies addressing weight gain in people on INSTI-based ART lack comparison with HIV-negative controls, which makes it hard to address excess weight gain compared to the non-HIV-positive population.…”

Epidemiology of obesity among people with HIV

“…Contemporaneous antiretroviral therapies (ART) [3], health-related behaviors [4], and food security [5]/insecurity [6] (depending on the population), have all been implicated in the rising prevalence of obesity among PWH. In the United States, for example, PWH from the HIV Heart Aging Study (85% male) were found to have higher body mass index (BMI) increases over a 5 year period compared to matched people without HIV from the German-based Heinz Nixdorf Recall Study [7 ▪▪ ]. Further, in the US Military HIV Natural History Study (93% male, 51% White), the prevalence of overweight status at HIV diagnosis increased from 25% between 1985 and 1990 to 41% between 1996 and 2004, whereas the prevalence of obesity increased from 3% to 12%.…”