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AIDS Research and Therapy
Published in: AIDS Research and Therapy 1/2016

Open Access 01-12-2016 | Research

High prevalence of being Overweight and Obese HIV-infected persons, before and after 24 months on early ART in the ANRS 12136 Temprano Trial

Authors: Calixte Guehi, Anani Badjé, Delphine Gabillard, Eric Ouattara, Serge Olivier Koulé, Raoul Moh, Didier Ekouevi, Hugues Ahibo, Jean Baptiste N’Takpé, Gérard Kouamé Menan, Nina Deschamps, Jerôme Lecarrou, Serge Eholié, Xavier Anglaret, Christine Danel

Published in: AIDS Research and Therapy | Issue 1/2016

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Abstract

Background

HIV is usually associated with weight loss. World health Organization (WHO) recommends early antiretroviral (ART) initiation, but data on the progression of body mass index (BMI) in participants initiating early ART in Africa are scarce.

Methods

The Temprano randomized trial was conducted in Abidjan to assess the effectiveness of early ART and Isoniazid (INH) prophylaxis for tuberculosis in HIV-infected persons with high CD4 counts below 800 cells/mm3 without any indication for starting ART. Patients initiating early ART before December 2010 were included in this sub-study. BMI was categorized as: underweight (<18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2) and obese (≥30 kg/m2). At baseline and after 24 months of ART, prevalence of being overweight or obese and factors associated with being overweight or obese were estimated using univariate and multivariate logistic regression.

Results

At baseline, 755 participants (78 % women; median CD4 count 442/mm3, median baseline BMI 22 kg/m2) initiated ART. Among them, 19.7 % were overweight, and 7.2 % were obese at baseline. Factors associated with being overweight or obese were: female sex aOR 2.3 (95 % CI 1.4–3.7), age, aOR for 5 years 1.01 (95 % CI 1.0–1.2), high living conditions aOR 2.6 (95 % CI 1.5–4.4), High blood pressure aOR 4.3 (95 % CI 2.0–9.2), WHO stage 2vs1 aOR 0.7 (95 % CI 0.4–1.0) and Hemoglobin ≥95 g/dl aOR 3.0 (95 % CI 1.6–5.8). Among the 597 patients who attended the M24 visit, being overweight or obese increased from 20.4 to 24.8 % (p = 0.01) and 7.2 to 9.2 % (p = 0.03) respectively and factor associated with being overweight or obese was immunological response measured as an increase of CD4 cell count between M0–M24 (for +50 cells/mm3: aOR 1.01; 95 % CI 1.05–1.13, p = 0.01).

Conclusion

The weight categories overweight and obese are highly prevalent in HIV-infected persons with high CD4 cell counts at baseline, and increased over 24 months on ART in this Sub-Saharan African population.
Appendix
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Literature
1.
2.
3.
Prevention. CfDCa. 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep. 1992; 41:1–19.
4.
5.
Mupere E, Malone L, Zalwango S, Chiunda A, Okwera A, Parraga I, et al. Lean tissue mass wasting is associated with increased risk of mortality among women with pulmonary tuberculosis in urban Uganda. Ann Epidemiol. 2012;22:466–73.PubMedCentralCrossRefPubMed
6.
El-Sadr WM, Lundgren J, Neaton JD, Gordin F, Abrams D, Arduino RC, et al. CD4 + count-guided interruption of antiretroviral treatment. N Engl J Med. 2006;355:2283–96.CrossRefPubMed
7.
De Wit S, Sabin CA, Weber R, Worm SW, Reiss P, Cazanave C, et al. Incidence and risk factors for new-onset diabetes in HIV-infected patients: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Diabetes Care. 2008;31:1224–9.PubMedCentralCrossRefPubMed
8.
Lang S, Mary-Krause M, Cotte L, Gilquin J, Partisani M, Simon A, et al. Increased risk of myocardial infarction in HIV-infected patients in France, relative to the general population. AIDS. 2010;24:1228–30.CrossRefPubMed
9.
Gazzaruso C, Bruno R, Garzaniti A, Giordanetti S, Fratino P, Sacchi P, et al. Hypertension among HIV patients: prevalence and relationships to insulin resistance and metabolic syndrome. J Hypertens. 2003;21:1377–82.CrossRefPubMed
10.
Wilson SL, Scullard G, Fidler SJ, Weber JN, Poulter NR. Effects of HIV status and antiretroviral therapy on blood pressure. HIV Med. 2009;6:388–94.CrossRef
11.
Lewden C, May T, Rosenthal E, Burty C, Bonnet F, Costagliola D, et al. Changes in causes of death among adults infected by HIV between 2000 and 2005: the “Mortalite 2000 and 2005” surveys (ANRS EN19 and Mortavic). J Acquir Immune Defic Syndr. 2008;48:590–8.CrossRefPubMed
12.
13.
14.
Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol. 2006;26:968–76.CrossRefPubMed
15.
Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006;113:898–918.CrossRefPubMed
16.
Crum-Cianflone N, Roediger MP, Eberly L, Headd M, Marconi V, Ganesan A, et al. Increasing rates of obesity among HIV-infected persons during the HIV epidemic. PLoS ONE. 2010;5:e10106.PubMedCentralCrossRefPubMed
17.
Crum-Cianflone N, Tejidor R, Medina S, Barahona I, Ganesan A. Obesity among patients with HIV: the latest epidemic. AIDS Patient Care STDS. 2008;22:925–30.PubMedCentralCrossRefPubMed
18.
Crum-Cianflone NF, Roediger M, Eberly LE, Vyas K, Landrum ML, Ganesan A, et al. Obesity among HIV-infected persons: impact of weight on CD4 cell count. AIDS. 2010;24:1069–72.PubMedCentralCrossRefPubMed
19.
Taylor BS, Liang Y, Garduno LS, Walter EA, Gerardi M, Anstead GM, et al. High Risk of Obesity and Weight Gain for HIV-Infected Uninsured Minorities. J Acquir Immune Defic Syndr. 2014;65:e33–40.PubMedCentralCrossRefPubMed
20.
21.
22.
23.
Koethe JR, Jenkins CA, Lau B, Shepherd BE, Silverberg MJ, Brown TT, et al. Body mass index and early CD4 T-cell recovery among adults initiating antiretroviral therapy in North America, 1998-2010. HIV Med. 2015;16:572–7.CrossRefPubMed
24.
Moh R, Danel C, Messou E, Ouassa T, Gabillard D, Anzian A, et al. Incidence and determinants of mortality and morbidity following early antiretroviral therapy initiation in HIV-infected adults in West Africa. AIDS. 2007;21:2483–91.CrossRefPubMed
25.
26.
27.
Bashi J, Balestre E, Messou E, Maiga M, Coffie PA, Zannou DM, et al. Time trends in demographic and clinical characteristics of adult patients on HAART initiation in West Africa. Med Mal Infect. 2010;40:449–55.PubMedCentralCrossRefPubMed
28.
Keiser O, Anastos K, Schechter M, Balestre E, Myer L, Boulle A, et al. Antiretroviral therapy in resource-limited settings 1996 to 2006: patient characteristics, treatment regimens and monitoring in sub-Saharan Africa, Asia and Latin America. Trop Med Int Health. 2008;13:870–9.CrossRefPubMed
29.
Nash D, Katyal M, Brinkhof MW, Keiser O, May M, Hughes R, et al. Long-term immunologic response to antiretroviral therapy in low-income countries: a collaborative analysis of prospective studies. AIDS. 2008;22:2291–302.PubMedCentralCrossRefPubMed
30.
Amorosa V, Synnestvedt M, Gross R, Friedman H, MacGregor RR, Gudonis D, et al. A tale of 2 epidemics: the intersection between obesity and HIV infection in Philadelphia. J Acquir Immune Defic Syndr. 2005;39:557–61.PubMed
31.
Duran AC, Almeida LB, Segurado AA, Jaime PC. Diet quality of persons living with HIV/AIDS on highly active antiretroviral therapy. J Hum Nutr Diet. 2008;21:346–50.CrossRefPubMed
32.
Hendricks KM, Willis K, Houser R, Jones CY. Obesity in HIV-infection: dietary correlates. J Am Coll Nutr. 2006;25:321–31.CrossRefPubMed
33.
Vernay M, Malon A, Oleko A, Salanave B, Roudier C, Szego E, et al. Association of socioeconomic status with overall overweight and central obesity in men and women: the French Nutrition and Health Survey 2006. BMC Public Health. 2009;9:215.PubMedCentralCrossRefPubMed
34.
35.
36.
Koethe JR, Jenkins CA, Lau B, Shepherd BE, Justice AC, Tate JP, et al. Rising Obesity Prevalence and Weight Gain Among Adults Starting Antiretroviral Therapy in the United States and Canada. AIDS Res Hum Retroviruses. 2015;53:952–60.
37.
Bouchard C. Genetics of obesity in humans: current issues. Ciba Found Symp. 1996;201:108–15.PubMed
38.
Bouchard C. The causes of obesity: advances in molecular biology but stagnation on the genetic front. Diabetologia. 1996;39:1532–3.CrossRefPubMed
39.
Bouchard C, Despres JP, Mauriege P. Genetic and nongenetic determinants of regional fat distribution. Endocr Rev. 1993;14:72–93.CrossRefPubMed
40.
Perusse L, Chagnon YC, Dionne FT, Bouchard C. The human obesity gene map: the 1996 update. Obes Res. 1997;5:49–61.CrossRefPubMed
41.
Gallo MF, Lopez LM, Grimes DA, Carayon F, Schulz KF, Helmerhorst FM. Combination contraceptives: effects on weight. Cochrane Database Syst Rev. 2014;1:CD003987.PubMed
42.
Yuh B, Tate J, Butt AA, Crothers K, Freiberg M, Leaf D, et al. Weight change after antiretroviral therapy and mortality. Clin Infect Dis. 2015;60:1852–9.CrossRefPubMed
43.
Koethe JR, Grome H, Jenkins CA, Kalams SA, Sterling TR. The metabolic and cardiovascular consequences of obesity in persons with HIV on long-term antiretroviral therapy. AIDS. 2015;30:83–91.
44.
Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309:71–82.CrossRefPubMed
45.
Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999;341:1097–105.CrossRefPubMed
46.
Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care. 1994;17:961–9.CrossRefPubMed
47.
Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005;366:1640–9.CrossRefPubMed
48.
Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation. 2008;117:1658–67.CrossRefPubMed
49.
Zhu S, Wang Z, Heshka S, Heo M, Faith MS, Heymsfield SB. Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Am J Clin Nutr. 2002;76:743–9.PubMed
50.
Gabillard D, Lewden C, Ndoye I, Moh R, Segeral O, Tonwe-Gold B, et al. Mortality, AIDS-morbidity, and loss to follow-up by current CD4 cell count among HIV-1-infected adults receiving antiretroviral therapy in Africa and Asia: data from the ANRS 12222 collaboration. J Acquir Immune Defic Syndr. 2013;62:555–61.PubMedCentralCrossRefPubMed
51.
Faber M, Kruger HS. Dietary intake, perceptions regarding body weight, and attitudes toward weight control of normal weight, overweight, and obese Black females in a rural village in South Africa. Ethn Dis. 2005;15:238–45.PubMed
52.
Kiawi E, Edwards R, Shu J, Unwin N, Kamadjeu R, Mbanya JC. Knowledge, attitudes, and behavior relating to diabetes and its main risk factors among urban residents in Cameroon: a qualitative survey. Ethn Dis. 2006;16:503–9.PubMed
Metadata
Title
High prevalence of being Overweight and Obese HIV-infected persons, before and after 24 months on early ART in the ANRS 12136 Temprano Trial
Authors
Calixte Guehi
Anani Badjé
Delphine Gabillard
Eric Ouattara
Serge Olivier Koulé
Raoul Moh
Didier Ekouevi
Hugues Ahibo
Jean Baptiste N’Takpé
Gérard Kouamé Menan
Nina Deschamps
Jerôme Lecarrou
Serge Eholié
Xavier Anglaret
Christine Danel
Publication date
01-12-2016
Publisher
BioMed Central
Published in
AIDS Research and Therapy / Issue 1/2016
Electronic ISSN: 1742-6405
DOI
https://doi.org/10.1186/s12981-016-0094-y

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