W. M. HanA. JiamsakulJ. JantarapakdeE. YunihastutiJ. Y. ChoiR. DitangcoR. ChaiwarithL. P. SunS. KhusuwanT. P. MeratiC. D. DoI. AzwaM. P. LeeK. Van NguyenY. J. ChanS. KiertiburanakulO. T. NgJ. TanumaS. PujariF. ZhangY. M. GaniS. SangleJ. RossN. KumarasamyHospital Sungai BulohBeijing Ditan Hospital Capital Medical UniversityVHS Medical Centre IndiaGokilaBach Mai HospitalUniversitas UdayanaUniversitas Indonesia, RSUPN Dr. Cipto MangunkusumoThe Kirby InstituteNational Center for Global Health and MedicineThe HIV Netherlands Australia Thailand Research CollaborationYonsei University College of MedicineFaculty of Medicine Ramathibodi Hospital, Mahidol UniversityQueen Elizabeth Hospital Hong KongUniversity of Malaya Medical CentreVeterans General Hospital-TaipeiTan Tock Seng HospitalBJ Government Medical College and Sassoon General HospitalNational Hospital for Tropical DiseasesNational Center for HIV/AIDSamfAR - The Foundation for AIDS ResearchResearch Institute for Health SciencesInstitute of Infectious DiseasesChiangrai Prachanukroh Hospital2022-08-042022-08-042021-04-01HIV Medicine. Vol.22, No.4 (2021), 294-30614681293146426622-s2.0-85102909777https://repository.li.mahidol.ac.th/handle/20.500.14594/78315Objectives: 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.Mahidol UniversityMedicineArticleSCOPUS10.1111/hiv.13017