Weight Change After Antiretroviral Therapy and Mortality

Yuh, Bianca; Tate, Janet; Butt, Adeel A.; Crothers, Kristina; Freiberg, Matthew; Leaf, David; Logeais, Mary; Rimland, David; Rodriguez-Barradas, Maria C.; Ruser, Christopher; Justice, Amy C.
June 2015
Clinical Infectious Diseases;Jun2015, Vol. 60 Issue 12, p1852
Academic Journal
Background: Weight gain after antiretroviral therapy (ART) initiation is common, but its implication for mortality is unknown. We evaluated weight change in the first year after ART initiation and its association with subsequent mortality. Methods: Human immunodeficiency virus-infected patients from the Veterans Aging Cohort Study (VACS) who initiated ART between 2000 and 2008, with weight recorded at baseline and 1 year later, were followed another 5 years for mortality. Baseline body mass index (BMI) was classified as underweight (<18.5 kg/m²), normal (18.5-24.9 kg/m²), overweight (25-29.9 kg/m²), and obese (≥30 kg/m²). We used multivariable Cox models to assess mortality risk with adjustment for disease severity using the VACS Index. Results: The sample consisted of 4184 men and 127 women with a mean age of 47.9 ± 10.0 years. After 1 year of ART, median weight change was 5.9 pounds (2.7 kg) (interquartile range, -2.9 to 17.0 pounds, -1.3 to 7.7 kg). Weight gain after ART initiation was associated with lower mortality among underweight and normal-weight patients. A minimum threshold of 10- to 19.9-pound (4.5 to 9.0 kg) weight gain was beneficial for normal-weight patients (hazard ratio, 0.56; 95% confidence interval, .41-.78), but there was no clear benefit to weight gain for overweight/obese patients. Baseline weight, CD4 cell count status, and hemoglobin level were strongly associated with weight gain. Risk for weight gain was higher among those with greater disease severity, regardless of weight at initiation. Conclusions: The survival benefits of weight gain after ART initiation are dependent on starting BMI. Weight gain after ART is associated with lower mortality for those who are not initially overweight.


Related Articles

  • Incidence and risk factors for tuberculosis in HIV-infected patients while on antiretroviral treatment in Cambodia. Choun, Kimcheng; Thai, Sopheak; Pe, Reaksmey; Lorent, Natalie; Lynen, Lutgarde; van Griensven, Johan // Transactions of the Royal Society of Tropical Medicine & Hygiene;Apr2013, Vol. 107 Issue 4, p235 

    Background Given the lack of detailed studies on tuberculosis (TB) in patients on antiretroviral treatment (ART) in South-East Asia, we aimed to determine the incidence and risk factors for early (after ≤6 months of ART) and late (after >6 months of ART) incident TB in Cambodia. Methods We...

  • The Effect of HIV and the Modifying Effect of Anti-Retroviral Therapy (ART) on Body Mass Index (BMI) and Blood Pressure Levels in Rural South Africa. Feigl, Andrea B.; Bloom, David E.; Danaei, Goodarz; Pillay, Deenan; Salomon, Joshua A.; Tanser, Frank; Bärnighausen, Till W. // PLoS ONE;8/23/2016, Vol. 11 Issue 8, p1 

    Background: High BMI and blood pressure are leading chronic disease risk factors in South Africa. Longterm effects of HIV and ART on adiposity and blood pressure are poorly understood, and direct comparisons of risk factor trajectories in HIV- versus HIV+ populations are rare. Methods: In 2003...

  • Study Reveals Link Between Obesity and Headache in Children. Spittler, Karen L. // Neurology Reviews;Sep2007, Vol. 15 Issue 9, p55 

    A conference paper about the association between obesity and pediatric headache in children is presented. It discusses the correlation of the body mass index with increased disability in children as well as the rates of medication use in children who lost weight and those children who gained weight.

  • Relationship between Body Mass Index and Mortality in HIV-Infected HAART Users in the Women's Interagency HIV Study. Sharma, Anjali; Hoover, Donald R.; Shi, Qiuhu; Gustafson, Deborah; Plankey, Michael W.; Hershow, Ronald C.; Tien, Phyllis C.; Golub, Elizabeth T.; Anastos, Kathryn // PLoS ONE;12/23/2015, Vol. 10 Issue 12, p1 

    Background: Early HIV studies suggested protective associations of overweight against mortality, yet data are lacking for the era of potent highly active antiretroviral therapy (HAART). We evaluated associations of pre-HAART initiation body mass index (BMI) with mortality among HAART-using...

  • Body Mass Index and CD4+ T-Lymphocyte Recovery in HIV-Infected Men with Viral Suppression on Antiretroviral Therapy. Palermo, Brandon; Bosch, Ronald J.; Bennett, Kara; Jacobson, Jeffrey M. // HIV Clinical Trials;Jul/Aug2011, Vol. 12 Issue 4, p222 

    Purpose: To better characterize the relationship between body mass index (BMI) and CD4+ T-lymphocyte recovery in HIV disease.Methods: We analyzed the association between baseline BMI and CD4+ T-lymphocyte increases, as well as the association between BMI and immune activation (CD38 and HLA-DR...

  • Obesity - New Threat to Croatian Longevity. Milanović, Sanja Musić; Ivanković, Davor; Uhernik, Ana Ivičević; Fišter, Kristina; Peternel, Renata; Vuletić, Silvije // Collegium Antropologicum;Jan2012 Supplement 1, Vol. 36, p113 

    The aim of this study was to examine the association of weight gain and life expectancy at birth in Croatia. Mean body mass index was based on the data from the Croatian Adult Health Survey 2003. Birth rate and mortality data needed for life expectancy calculation were supplied by the Central...

  • Revisional Bariatric Surgery for Unsuccessful Weight Loss and Complications. Shimizu, Hideharu; Annaberdyev, Shohrat; Motamarry, Isaac; Kroh, Matthew; Schauer, Philip; Brethauer, Stacy // Obesity Surgery;Nov2013, Vol. 23 Issue 11, p1766 

    Background: There are growing numbers of patients who require revisional bariatric surgery due to the undesirable results of their primary procedures. The aim of this study was to review our experience with bariatric patients undergoing revisional surgery. Methods: We conducted a retrospective...

  • Variations in the obesity genes FTO, TMEM18 and NRXN3 influence the vulnerability of children to weight gain induced by short sleep duration. Prats-Puig, A; Grau-Cabrera, P; Riera-Pérez, E; Cortés-Marina, R; Fortea, E; Soriano-Rodríguez, P; de Zegher, F; Ibánez, L; Bassols, J; López-Bermejo, A // International Journal of Obesity;Feb2013, Vol. 37 Issue 2, p182 

    OBJECTIVE:Shorter sleep duration predisposes to obesity, but the mechanisms whereby sleep deprivation affects body weight are poorly understood. We tested whether this association is modulated by the obesity genes FTO, TMEM18 and NRXN3.SUBJECTS:Body mass index (BMI), waist circumference,...

  • Birth weight; postnatal, infant, and childhood growth; and obesity in young adulthood: evidence from the Barry Caerphilly Growth Study.  // American Journal of Clinical Nutrition;Oct2007, Vol. 86 Issue 4, p907 

    The article discusses the study which examines the association of the measurement of growth between five-year of age and birth with adult measures of adiposity. The study reexamined 679 people whose body mass index (BMI), waist circumference, and sagittal abdominal diameter was measured. Results...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics