Weight change after antiretroviral therapy initiation among adults living with HIV in Northwest Ethiopia: a longitudinal data analysis

Abstract

ObjectivesThe first objective was to explore weight change in the first 2 years after antiretroviral therapy (ART) initiation in adults living with HIV. The second objective was to identify the predictors of weight change over time among adults living with HIV on ART.DesignAn institution-based retrospective longitudinal study was conducted.SettingThe study was conducted at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.ParticipantsThe study included 848 randomly selected medical charts of adults living with HIV receiving ART between June 2014 and June 2020.Primary and secondary outcomesThe primary outcome was weight change in the first 2 years after ART initiation. The secondary outcome was to identify predictors of weight change. Association between predictor variables and weight change was assessed using an LMM. Variables with p values <0.05 in the final model were considered as statistically significant predictors of weight change.ResultsOf 844 study participants, more than half (n=499; 58.8%) were female. Participants’ mean weight increased from 54.2 kg (SD ±9.6 kg) at baseline to 59.5 kg (SD ±10.7 kg) at the end of follow-up. Duration of time on ART, sex, WHO clinical disease staging, functional status, nutritional status and presence of opportunistic infections were significant predictors of weight change at ART initiation. Significant interaction effects were observed between time and sex, WHO clinical disease staging, functional status, isoniazid preventive therapy and nutritional status.ConclusionWe found a linear increment of weight over 24 months of follow-up. Rate of weight gain over time was lower in patients with advanced disease stage and working functional status, whereas weight gain rate was higher in male and underweight patients.

Association Between Body Mass Index Variation and Early Mortality Among 834 Ethiopian Adults Living with HIV on ART: A Joint Modelling Approach

“…In this study, patients who experienced OIs had a lower mean BMI at ART initiation but higher BMI increase over time, which aligns with previous studies [ 34 , 35 ]. Higher BMI increase over time in patients with OIs could be the restoration of healthy pre-infection weight, known as the “return-to-health” phenomenon [ 30 ], reflecting effects of ART, as it significantly reduces the occurrence and recurrence of OIs and improves gastrointestinal function, appetite, and nutrient absorption [ 30 ].…”

Trends of Body Mass Index changes among adults on antiretroviral therapy in Northwest Ethiopia: a longitudinal data analysis

“…The BMI increment status of HIV-positive adults with advanced HIV stages is low compared to patients with WHO stages I or II clinical illnesses. The finding is supported by prior studies conducted in Ethiopia 25 , 32 , 34 , 54 , Zimbabwe 55 , Nepal 56 and USA 40 . The decline in BMI status might be due to the presence of high nutritional requirements or calorie expenditures and the poor appetite and absorption of nutrients in individuals with advanced-stage clinical disease 4 .…”