Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV

the the TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific

doi:10.1111/hiv.13017

Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV

the the TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Objectives: We conducted a longitudinal cohort analysis to evaluate the association of pre-treatment body mass index (BMI) with CD4 recovery, virological failure (VF) and cardiovascular risk disease (CVD) markers among people living with HIV (PLHIV). Methods: Participants who were enrolled between January 2003 and March 2019 in a regional Asia HIV cohort with weight and height measurements prior to antiretroviral therapy (ART) initiation were included. Factors associated with mean CD4 increase were analysed using repeated-measures linear regression. Time to first VF after 6 months on ART and time to first development of CVD risk markers were analysed using Cox regression models. Sensitivity analyses were done adjusting for Asian BMI thresholds. Results: Of 4993 PLHIV (66% male), 62% had pre-treatment BMI in the normal range (18.5–25.0 kg/m²), while 26%, 10% and 2% were underweight (< 18.5 kg/m²), overweight (25–30 kg/m2) and obese (> 30 kg/m²), respectively. Both higher baseline and time-updated BMI were associated with larger CD4 gains compared with normal BMI. After adjusting for Asian BMI thresholds, higher baseline BMIs of 23–27.5 and > 27.5 kg/m² were associated with larger CD4 increases of 15.6 cells/µL [95% confidence interval (CI): 2.9–28.3] and 28.8 cells/µL (95% CI: 6.6–50.9), respectively, compared with normal BMI (18.5–23 kg/m²). PLHIV with BMIs of 25–30 and > 30 kg/m² were 1.27 times (95% CI: 1.10–1.47) and 1.61 times (95% CI: 1.13–2.24) more likely to develop CVD risk factors. No relationship between pre-treatment BMI and VF was observed. Conclusions: High pre-treatment BMI was associated with better immune reconstitution and CVD risk factor development in an Asian PLHIV cohort.

Original language	English
Pages (from-to)	294-306
Number of pages	13
Journal	HIV Medicine
Volume	22
Issue number	4
DOIs	https://doi.org/10.1111/hiv.13017
Publication status	Published - 2021 Apr

Bibliographical note

Funding Information:
This work was supported by the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Heart, Lung, and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned here. Financial disclosure: Eunice Kennedy Shriver

Publisher Copyright:
© 2020 British HIV Association

All Science Journal Classification (ASJC) codes

Health Policy
Infectious Diseases
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/hiv.13017

Cite this

@article{4711a13f2c99403dadd201fa3b05ddbf,

title = "Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV",

abstract = "Objectives: We conducted a longitudinal cohort analysis to evaluate the association of pre-treatment body mass index (BMI) with CD4 recovery, virological failure (VF) and cardiovascular risk disease (CVD) markers among people living with HIV (PLHIV). Methods: Participants who were enrolled between January 2003 and March 2019 in a regional Asia HIV cohort with weight and height measurements prior to antiretroviral therapy (ART) initiation were included. Factors associated with mean CD4 increase were analysed using repeated-measures linear regression. Time to first VF after 6 months on ART and time to first development of CVD risk markers were analysed using Cox regression models. Sensitivity analyses were done adjusting for Asian BMI thresholds. Results: Of 4993 PLHIV (66% male), 62% had pre-treatment BMI in the normal range (18.5–25.0 kg/m2), while 26%, 10% and 2% were underweight (< 18.5 kg/m2), overweight (25–30 kg/m2) and obese (> 30 kg/m2), respectively. Both higher baseline and time-updated BMI were associated with larger CD4 gains compared with normal BMI. After adjusting for Asian BMI thresholds, higher baseline BMIs of 23–27.5 and > 27.5 kg/m2 were associated with larger CD4 increases of 15.6 cells/µL [95% confidence interval (CI): 2.9–28.3] and 28.8 cells/µL (95% CI: 6.6–50.9), respectively, compared with normal BMI (18.5–23 kg/m2). PLHIV with BMIs of 25–30 and > 30 kg/m2 were 1.27 times (95% CI: 1.10–1.47) and 1.61 times (95% CI: 1.13–2.24) more likely to develop CVD risk factors. No relationship between pre-treatment BMI and VF was observed. Conclusions: High pre-treatment BMI was associated with better immune reconstitution and CVD risk factor development in an Asian PLHIV cohort.",

author = "{the the TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific} and Han, {W. M.} and A. Jiamsakul and J. Jantarapakde and E. Yunihastuti and Choi, {J. Y.} and R. Ditangco and R. Chaiwarith and Sun, {L. P.} and S. Khusuwan and Merati, {T. P.} and Do, {C. D.} and I. Azwa and Lee, {M. P.} and {Van Nguyen}, K. and Chan, {Y. J.} and S. Kiertiburanakul and Ng, {O. T.} and J. Tanuma and S. Pujari and F. Zhang and Gani, {Y. M.} and S. Sangle and J. Ross and N. Kumarasamy",

note = "Funding Information: This work was supported by the U.S. National Institutes of Health{\textquoteright}s National Institute of Allergy and Infectious Diseases, the National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Heart, Lung, and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned here. Financial disclosure: Eunice Kennedy Shriver Publisher Copyright: {\textcopyright} 2020 British HIV Association",

year = "2021",

month = apr,

doi = "10.1111/hiv.13017",

language = "English",

volume = "22",

pages = "294--306",

journal = "HIV Medicine",

issn = "1464-2662",

publisher = "Wiley-Blackwell",

number = "4",

}

TY - JOUR

T1 - Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV

AU - the the TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific

AU - Han, W. M.

AU - Jiamsakul, A.

AU - Jantarapakde, J.

AU - Yunihastuti, E.

AU - Choi, J. Y.

AU - Ditangco, R.

AU - Chaiwarith, R.

AU - Sun, L. P.

AU - Khusuwan, S.

AU - Merati, T. P.

AU - Do, C. D.

AU - Azwa, I.

AU - Lee, M. P.

AU - Van Nguyen, K.

AU - Chan, Y. J.

AU - Kiertiburanakul, S.

AU - Ng, O. T.

AU - Tanuma, J.

AU - Pujari, S.

AU - Zhang, F.

AU - Gani, Y. M.

AU - Sangle, S.

AU - Ross, J.

AU - Kumarasamy, N.

N1 - Funding Information: This work was supported by the U.S. National Institutes of Health’s National Institute of Allergy and Infectious Diseases, the National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Heart, Lung, and Blood Institute, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, UNSW Sydney. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned here. Financial disclosure: Eunice Kennedy Shriver Publisher Copyright: © 2020 British HIV Association

PY - 2021/4

Y1 - 2021/4

N2 - Objectives: We conducted a longitudinal cohort analysis to evaluate the association of pre-treatment body mass index (BMI) with CD4 recovery, virological failure (VF) and cardiovascular risk disease (CVD) markers among people living with HIV (PLHIV). Methods: Participants who were enrolled between January 2003 and March 2019 in a regional Asia HIV cohort with weight and height measurements prior to antiretroviral therapy (ART) initiation were included. Factors associated with mean CD4 increase were analysed using repeated-measures linear regression. Time to first VF after 6 months on ART and time to first development of CVD risk markers were analysed using Cox regression models. Sensitivity analyses were done adjusting for Asian BMI thresholds. Results: Of 4993 PLHIV (66% male), 62% had pre-treatment BMI in the normal range (18.5–25.0 kg/m2), while 26%, 10% and 2% were underweight (< 18.5 kg/m2), overweight (25–30 kg/m2) and obese (> 30 kg/m2), respectively. Both higher baseline and time-updated BMI were associated with larger CD4 gains compared with normal BMI. After adjusting for Asian BMI thresholds, higher baseline BMIs of 23–27.5 and > 27.5 kg/m2 were associated with larger CD4 increases of 15.6 cells/µL [95% confidence interval (CI): 2.9–28.3] and 28.8 cells/µL (95% CI: 6.6–50.9), respectively, compared with normal BMI (18.5–23 kg/m2). PLHIV with BMIs of 25–30 and > 30 kg/m2 were 1.27 times (95% CI: 1.10–1.47) and 1.61 times (95% CI: 1.13–2.24) more likely to develop CVD risk factors. No relationship between pre-treatment BMI and VF was observed. Conclusions: High pre-treatment BMI was associated with better immune reconstitution and CVD risk factor development in an Asian PLHIV cohort.

AB - Objectives: We conducted a longitudinal cohort analysis to evaluate the association of pre-treatment body mass index (BMI) with CD4 recovery, virological failure (VF) and cardiovascular risk disease (CVD) markers among people living with HIV (PLHIV). Methods: Participants who were enrolled between January 2003 and March 2019 in a regional Asia HIV cohort with weight and height measurements prior to antiretroviral therapy (ART) initiation were included. Factors associated with mean CD4 increase were analysed using repeated-measures linear regression. Time to first VF after 6 months on ART and time to first development of CVD risk markers were analysed using Cox regression models. Sensitivity analyses were done adjusting for Asian BMI thresholds. Results: Of 4993 PLHIV (66% male), 62% had pre-treatment BMI in the normal range (18.5–25.0 kg/m2), while 26%, 10% and 2% were underweight (< 18.5 kg/m2), overweight (25–30 kg/m2) and obese (> 30 kg/m2), respectively. Both higher baseline and time-updated BMI were associated with larger CD4 gains compared with normal BMI. After adjusting for Asian BMI thresholds, higher baseline BMIs of 23–27.5 and > 27.5 kg/m2 were associated with larger CD4 increases of 15.6 cells/µL [95% confidence interval (CI): 2.9–28.3] and 28.8 cells/µL (95% CI: 6.6–50.9), respectively, compared with normal BMI (18.5–23 kg/m2). PLHIV with BMIs of 25–30 and > 30 kg/m2 were 1.27 times (95% CI: 1.10–1.47) and 1.61 times (95% CI: 1.13–2.24) more likely to develop CVD risk factors. No relationship between pre-treatment BMI and VF was observed. Conclusions: High pre-treatment BMI was associated with better immune reconstitution and CVD risk factor development in an Asian PLHIV cohort.

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DO - 10.1111/hiv.13017

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JO - HIV Medicine

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Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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