Obesity among Patients with HIV: The Latest Epidemic

Crum-Cianflone, Nancy F.; Tejidor, Raechel; Medina, Sheila; Barahona, Irma; Ganesan, Anuradha

doi:10.1089/apc.2008.0082

Cited by 158 publications

(184 citation statements)

References 25 publications

Supporting

Mentioning

154

Contrasting

Unclassified

Order By: Relevance

“…Obesity also emerged as a relatively strong predictor for comorbidity and with a striking prevalence of 27% in our population. Given the growing epidemic of obesity among HIV-infected patients in the United States 16 and the role of obesity in cardiovascular-related disease development, this will undoubtedly become an important topic both for future research and for clinicians when counseling patients. Finally, our results indicate that guideline-based recommendations for comorbidity-related disease monitoring and treatment goals are inconsistently met in HIVinfected patients.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity-Related Treatment Outcomes among HIV-Infected Adults in the Bronx, NY

et al. 2011

View full text Add to dashboard Cite

Aging, HIV infection, and antiretroviral therapy have been associated with increasing rates of chronic comorbidities in patients with HIV. Urban minority populations in particular are affected by both the HIV/AIDS and chronic disease epidemics. Our objectives were to estimate the prevalence of and risk factors for hypertension, dyslipidemia, and diabetes among HIV-infected adults in the Bronx and describe comorbidity-related treatment outcomes. This was a cross-sectional study of 854 HIV-positive adults receiving care at 11 clinics which provide HIV primary care services; clinics were affiliated with a large urban academic medical center. Data on blood pressure (BP), cholesterol, and glycemic control were collected through standardized chart review of outpatient medical records. We found prevalence rates of 26%, 48%, and 13% for hypertension, dyslipidemia, and diabetes, respectively. Older age, obesity, family history, and current protease inhibitor use were consistently associated with comorbidity. Diabetes treatment goals were achieved less often than BP and lipid goals, and concurrent diabetes was a significant predictor for BP and lipid control. In conclusion, major cardiovascular-related comorbidities are prevalent among HIVpositive adults in the Bronx, especially older and obese individuals. Differences exist in comorbidity-related treatment outcomes, especially for patients with concurrent diabetes. Because cardiovascular risk is modifiable, effective treatment of related comorbidities may improve morbidity and mortality in HIV-infected patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Comorbidity-Related Treatment Outcomes among HIV-Infected Adults in the Bronx, NY

et al. 2011

View full text Add to dashboard Cite

show abstract

“…33 In addition to these sleep disorders, PLWH are increasingly developing typical risk factors for OSA such as obesity and aging. 20,22,34,35 Conditions like insomnia, poor night time sleep, and excessive daytime sleepiness may also directly result from the frequent arousals caused by OSA and can have important consequences that influence HIV disease outcomes such as adherence to medications. 36 There remains a paucity of studies that have explored the association of OSA with fatigue and other sleep disorders in PLWH.…”

Section: Sleep Apnea and Fatigue In Hiv 593mentioning

confidence: 99%

Sleep Apnea Symptoms as a Predictor of Fatigue in an Urban HIV Clinic

Goswami

Baker

Wang

et al. 2015

AIDS Patient Care and STDs

View full text Add to dashboard Cite

Fatigue is common among persons living with HIV (PLWH), and risk factors for obstructive sleep apnea (OSA) such as older age and obesity are increasingly prevalent. Studies of OSA among PLWH are lacking, so we aimed to characterize OSA symptoms and associated clinical consequences (e.g., fatigue) among a contemporary population of PLWH. Self-administered surveys containing 23 items that included self-reported snoring, witnessed apneas, estimated sleep duration, the Epworth Sleepiness Score (ESS), and the FACIT-Fatigue score were mailed to PLWH receiving care at an urban HIV clinic. Clinical/demographic data were collected from the medical record. Multivariable linear regression models were created to study relationships between fatigue, clinical variables, and OSA symptoms. Of 535 surveys, 203 (38%) responded. Eight patients (3.9%) had known OSA. Among those without known OSA, mean respondent characteristics included: age 47 years; 80% male, 41% African American, 48% Caucasian, BMI 26.4 kg/m 2 , duration of HIV diagnosis 12 years, 93% on antiretroviral therapy, and 81% with <50 HIV RNA copies/mL. 27% reported snoring, 24% reported witnessed apneas, and 38% had excessive daytime sleepiness. Witnessed apnea was the strongest independent predictor of fatigue (lower FACIT-Fatigue score; b = -6.49; p < 0.001); this difference of 6.49 points exceeds the accepted minimal clinically important difference of 3.0 points. Other predictors included opioid use (b = -5.53; p < 0.001), depression (b = -4.18; p = 0.02), antidepressant use (b = -4.25; p = 0.02), and sleep duration < 6 h (b = -3.42; p = 0.02). Our data strongly support the need for increased efforts directed at OSA screening and treatment in PLWH.

show abstract

“…Obesity is a greater problem in cART-exposed patients than is wasting [Crum-Cianflone et al 2008]. Insulin has not been reported to interact with cART.…”

Section: Diabetesmentioning

confidence: 99%

HIV stroke risk: evidence and implications

Singer¹,

Valdes-Sueiras

Commins

et al. 2013

Therapeutic Advances in Chronic Disease

View full text Add to dashboard Cite

An estimated 34 million men, women, and children are infected with human immunodeficiency virus type 1 (HIV-1), the virus that causes acquired immunodeficiency syndrome (AIDS). Current technology cannot eradicate HIV-1, and most patients with HIV-1-infection (HIV+) will require lifelong treatment with combined antiretroviral therapy (cART). Stroke was recognized as a complication of HIV-1 infection since the early days of the epidemic. Potential causes of stroke in HIV-1 include opportunistic infections, tumors, atherosclerosis, diabetes, hypertension, autoimmunity, coagulopathies, cardiovascular disease, and direct HIV-1 infection of the arterial wall. Ischemic stroke has emerged as a particularly significant neurological complication of HIV-1 and its treatment due to the aging of the HIV+ population, chronic HIV-1 infection, inflammation, and prolonged exposure to cART. New prevention and treatment strategies tailored to the needs of the HIV+ population are needed to address this issue.

show abstract

Obesity among Patients with HIV: The Latest Epidemic

Cited by 158 publications

References 25 publications

Comorbidity-Related Treatment Outcomes among HIV-Infected Adults in the Bronx, NY

Comorbidity-Related Treatment Outcomes among HIV-Infected Adults in the Bronx, NY

Sleep Apnea Symptoms as a Predictor of Fatigue in an Urban HIV Clinic

HIV stroke risk: evidence and implications

Contact Info

Product

Resources

About