Increasing Rates of Obesity among HIV-Infected Persons during the HIV Epidemic

Abstract

BackgroundThe prevalence and factors associated with overweight/obesity among human immunodeficiency virus (HIV)-infected persons are unknown.MethodsWe evaluated prospective data from a U.S. Military HIV Natural History Study (1985–2004) consisting of early diagnosed patients. Statistics included multivariate linear regression and longitudinal linear mixed effects models.ResultsOf 1682 patients, 2% were underweight, 37% were overweight, and 9% were obese at HIV diagnosis. Multivariate predictors of a higher body mass index (BMI) at diagnosis included more recent year of HIV diagnosis, older age, African American race, and earlier HIV stage (all p<0.05). The majority of patients (62%) gained weight during HIV infection. Multivariate factors associated with a greater increase in BMI during HIV infection included more recent year of diagnosis, lower BMI at diagnosis, higher CD4 count, lower HIV RNA level, lack of AIDS diagnosis, and longer HIV duration (all p<0.05). Nucleoside agents were associated with less weight gain; other drug classes had no significant impact on weight change in the HAART era.ConclusionsHIV-infected patients are increasingly overweight/obese at diagnosis and during HIV infection. Weight gain appears to reflect improved health status and mirror trends in the general population. Weight management programs may be important components of HIV care.

Comprehensive and Medically Appropriate Food Support Is Associated with Improved HIV and Diabetes Health

“…The focus on medically appropriate food assistance embodied by Food = Medicine and other similar interventions is especially salient given the need to address concurrent food insecurity and obesity in chronically ill populations. HIV-specific food assistance in resourcepoor settings is generally tailored for underweight populations, although treated populations with HIV increasingly have higher BMIs [48,49]. We previously showed that providing energy-dense forms of food assistance to overweight or obese, food-insecure individuals with treated HIV infection leads to weight gain [50], increasing the risk for chronic comorbidities.…”

Bariatric surgery: An HIV-positive patient’s successful journey

“…Diagnosed at antenatal screening in 2007, she had been on HAART for four years with a suppressed viral load (less than 34 copies per ml) and CD4 count of 680 cells/ mm 3 at the time of surgery. Prior to surgery, she lost 26 kg through a combination of diet and exercise; however, her weight had stabilised at 154 kg.…”

“…1 Obesity in HIV is a worrying trend with highly active antiretroviral therapy (HAART) independently associated with metabolic syndrome. 2,3 Bariatric surgery has been shown to be more effective than conservative measures in the remission of metabolic syndrome. 4 So far little research has been done looking at bariatric surgery in HIV patients.…”

Adiponectin Levels and Coronary Artery Disease among HIV-Infected Men

“…Obesity is associated with reduced plasma adiponectin levels, and rates of obesity are increasing among HIV-infected persons [45,46]. Further, HIV patients are predisposed to lipodystrophy, likely an effect of both HIV itself and antiretroviral agents [17,47].…”