@article{0a03554a38214842951fdf324c74ed90,
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.",
keywords = "HIV, body mass index, cardiovascular risks, immune recovery, virological response",
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 and Ly, {P. S.} and V. Khol and Zhang, {F. J.} and Zhao, {H. X.} and N. Han and Lee, {M. P.} and Li, {P. C.K.} and Kwong, {T. S.} and Chan, {Y. T.} and N. Kumarasamy and C. Ezhilarasi and S. Pujari and K. Joshi and S. Gaikwad and A. Chitalikar and S. Sangle and V. Mave and I. Marbaniang and S. Nimkar and Merati, {T. P.} and Wirawan, {D. N.} and F. Yuliana and E. Yunihastuti and A. Widhani and S. Maria and Ross, {J. L.}",
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 = "2020",
doi = "10.1111/hiv.13017",
language = "English (US)",
journal = "HIV Medicine",
issn = "1464-2662",
publisher = "Wiley-Blackwell",
}