Publication: Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV
Issued Date
2021-04-01
Resource Type
ISSN
14681293
14642662
14642662
Other identifier(s)
2-s2.0-85102909777
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Mahidol University
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SCOPUS
Bibliographic Citation
HIV Medicine. Vol.22, No.4 (2021), 294-306
Suggested Citation
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 Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV. HIV Medicine. Vol.22, No.4 (2021), 294-306. doi:10.1111/hiv.13017 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78315
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Title
Association of body mass index with immune recovery, virological failure and cardiovascular disease risk among people living with HIV
Other Contributor(s)
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
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
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.