Browsing by Author "W. M. Han"

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    Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV
    (2021-04-01) W. M. Han; A. Jiamsakul; J. Jantarapakde; E. Yunihastuti; J. Y. Choi; R. Ditangco; R. Chaiwarith; L. P. Sun; S. Khusuwan; T. P. Merati; C. D. Do; I. Azwa; M. P. Lee; K. Van Nguyen; Y. J. Chan; S. Kiertiburanakul; O. T. Ng; J. Tanuma; S. Pujari; F. Zhang; Y. M. Gani; S. Sangle; J. Ross; N. Kumarasamy; Hospital Sungai Buloh; Beijing Ditan Hospital Capital Medical University; VHS Medical Centre India; Gokila; Bach Mai Hospital; Universitas Udayana; Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo; The Kirby Institute; National Center for Global Health and Medicine; The HIV Netherlands Australia Thailand Research Collaboration; Yonsei University College of Medicine; Faculty of Medicine Ramathibodi Hospital, Mahidol University; Queen Elizabeth Hospital Hong Kong; University of Malaya Medical Centre; Veterans General Hospital-Taipei; Tan Tock Seng Hospital; BJ Government Medical College and Sassoon General Hospital; National Hospital for Tropical Diseases; National Center for HIV/AIDS; amfAR - The Foundation for AIDS Research; Research Institute for Health Sciences; Institute of Infectious Diseases; Chiangrai Prachanukroh Hospital
    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.