Risk factors associated with overweight and obesity in HIV-infected people

Obry-Roguet, Véronique; Brégigeon, Sylvie; Cano, Carla E.; Lions, C.; Zaegel-Faucher, Olivia; Laroche, Hélène; Galie, Sébastien; Lamarlière, P Geneau de; Orticoni, M; Soavi, M.J.; Saout, A.; Poizot‐Martin, Isabelle

doi:10.1097/md.0000000000010956

Cited by 32 publications

(25 citation statements)

References 31 publications

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“…ART suppresses viral replication and increases CD4 count resulting in the restoration of recipients' health status [25]. us, the BMI change observed among the recipients herein might result from a natural process or interplay of different factors [11,15,26]. By preventing the advancement of HIV infection, ART allows other bodily processes to proceed normally and increase the recipients' weight.…”

Section: Characteristicsmentioning

confidence: 99%

“…However, a study by Todd and colleagues [10] unearthed associations between Nucleoside Reverse Transcriptase Inhibitors (NRTI) and increased odds of hyperinsulinemia, whereas cumulative exposure to Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) or PI drugs lacked association with insulin resistance markers or correlates of DRC and overweight/obesity. Recent work by Obry-Roguet and co-workers [11] failed to identify any association between all ART combinations and overweight/obesity. eir results partly support previous reports by Hasse and colleagues [12] that only limited associations existed between ART and overweight/obesity.…”

Section: Introductionmentioning

confidence: 99%

“…is is because at this particular stage PLWH can gain weight just as the general population. Nutritional, sociodemographic, economic, biomedical, genetic, psychological, emotional, and behavioural factors like alcohol, tobacco, and substance use have all been associated with BMI change [11,16]. ese factors cannot be ignored when investigating the effects of ART on BMI change.…”

Section: Introductionmentioning

confidence: 99%

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Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Gaborone, Botswana: Factors Associated with Change in Body Mass Index

Tshikuka

Magafu

Rankgoane-Pono

et al. 2020

AIDS Research and Treatment

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Background. Factors associated with overweight/obesity among antiretroviral therapy (ART) recipients have not been sufficiently studied in Botswana. Objectives. To: (i) estimate the prevalence and trends in overweight/obesity by duration of exposure to ART among recipients, (ii) assess changes in BMI categories among ART recipients between their first clinic visit (BMI-1) and their last clinic visit (BMI-2), (iii) identify ART regimen that predicts overweight/obesity better than the others and factors associated with BMI changes among ART recipients. Methods. A 12-year retrospective record-based review was conducted. Potential predictors of BMI change among patients after at least three years of ART exposure were examined using a multiple logistic regression model. Adjusted odds ratios (AOR) and their 95% confidence intervals (CIs) were computed. ART regimens, duration of exposure to ART, and recipients’ demographic and biomedical characteristics including the presence or absence of diabetes mellitus-related comorbidities (DRC), defined as any morbidity associated with type 2 diabetes as described in the international statistical classification of diseases and related health problems (ICD-10-CM) codebook index, were investigated as potential predictors of overweight/obesity. Results. Twenty-nine percent of recipients were overweight, 16.6% had obesity of whom 2.4% were morbidly-obese at the last clinic visit. Overweight/obese recipients were more likely to be female, to have DRC and less likely to have CD4 count between 201 and 249 cells/mm3. Neither the first-line nor the second-, third-line ART regimens predicted overweight/obesity better than the other and neither did the duration of exposure to ART. No significant linear trends were observed in the prevalence of overweight/obesity by the duration of exposure to ART. Conclusion. These results suggest that the ART regimens studied have a comparable effect on overweight/obesity and that the duration of exposure does not affect the outcome. This study calls for further research to elucidate the relative contribution of various factors to BMI change among recipients, including ART regimens.

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Section: Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Gaborone, Botswana: Factors Associated with Change in Body Mass Index

Tshikuka

Magafu

Rankgoane-Pono

et al. 2020

AIDS Research and Treatment

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“…Patients in the normal weight group had a longer median period of ART than patients with overweight or obesity. Previously, a cross-sectional study with 862 patients with 21.5 years of HIV infection follow-up also concluded that the prevalence of overweight and obesity was not influenced by the duration of infection ( 64 ). A meta-analysis on the association of ART with overweight/obesity also did not find a significant association ( 64 ).…”

Section: Discussionmentioning

confidence: 98%

“…Previously, a cross-sectional study with 862 patients with 21.5 years of HIV infection follow-up also concluded that the prevalence of overweight and obesity was not influenced by the duration of infection ( 64 ). A meta-analysis on the association of ART with overweight/obesity also did not find a significant association ( 64 ). In contrast, other studies showed a higher BMI in patients who received ART ( 65 ), with significant weight gain after starting ART ( 3 , 66 ).…”

Section: Discussionmentioning

confidence: 98%

Metabolically Healthy or Metabolically Unhealthy Obese HIV-Infected Patients: Mostly a Matter of Age?

et al. 2018

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Background: Life expectancy of HIV-infected patients has increased with antiretroviral treatment (ART). Chronic diseases associated with aging, including metabolic and cardiovascular diseases are becoming more prevalent in this population. We aimed to evaluate the association of obesity and aging with cardiometabolic comorbidities and metabolic health status among patients with HIV infection.Methods: We evaluated 580 HIV-1 infected patients (71.7% male, mean age of 47.7 ± 11.5 years). We analyzed the association of age and obesity (defined by and by central obesity) with gender, duration of HIV infection, and ART, anthropometric parameters, cardiometabolic comorbidities, Framingham risk score (FRS), blood pressure, lipid profile, uric acid, liver biochemical tests, and glycemic profile. Furthermore, we analyzed the above-mentioned associations according to the category and central obesity into the metabolically healthy (MH) and unhealthy (MUH) categories. To evaluate the association of anthropometric parameters with cardiometabolic comorbidities, we performed unadjusted and adjusted logistic regression models.Results: The prevalence of excessive weight and cardiometabolic comorbidities increased with age. Patients with normal weight were younger and there was a higher proportion of female patients in the obesity group. The prevalence of hypertension and metabolic syndrome were higher among patients who were overweight or with obesity. The FRS was higher among patients with obesity. The proportion of MUH patients was higher among patients with excessive weight and central obesity. MUH patients had more cardiometabolic comorbidities and a higher FRS. In the normal weight group, MUH patients were older, and in the obesity group they were more likely to be male. The anthropometric parameter most associated with metabolic syndrome was waist circumference and that most associated with hypertension was waist-to-height ratio. The anthropometric parameter most associated with diabetes and FRS was waist-to-hip ratio.Conclusion: Patients with HIV present a high prevalence of obesity and related comorbidities. Ageing significantly contributes to metabolic dysfunction in this population. The proportion of MUH patients is higher among groups with excessive weight and central obesity, with those patients presenting a higher cardiovascular risk. Our results highlight the importance of evaluating and addressing obesity in patients with HIV, as well as metabolic comorbidities and cardiovascular risk.

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