Changes in body mass index following HAART initiation among HIVinfected women in the women’s interagency HIV study

Anjali Sharma, Shalanda A. Bynum, Michael F. Schneider, Christopher Cox, Phyllis C. Tien, Ronald C. Hershow, Deborah Gustafson, Michael W. Plankey

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: Examine changes in, and factors associated with changing body mass index (BMI) in women following highly active antiretroviral therapy (HAART) initiation. Methods: 1177 HIV-infected Women’s Interagency HIV Study participants who contributed 10,754 years of followup following HAART initiation were studied. Changes in median BMI up to 15 years following HAART initiation, and the highest and lowest BMI reached following HAART initiation were summarized by pre-HAART BMI category (<18.5 [underweight], 18.5-<25.0 [normal weight], 25.0-<30.0 [overweight], 30.0-<40.0 [obese], and ≥ 40.0 [morbidly obese]). Multivariate mixed effects ordinal logistic regression estimated the degree of association of each exposure of interest with post-HAART BMI. Results: Before HAART, 39% percent of women had normal BMI, 31% were overweight, 23% were obese, and 5% were morbidly obese. Following HAART initiation, median BMI change (per 5 years) was 0.21 kg/m2 (90% confidence interval [CI]: -1.33, 0.42) for those with normal pre-HAART BMI, 0.39 kg/m2 (90% CI: 0.15,0.66) for overweight, 0.31 kg/ m2 (90% CI: -1.18,0.67) for obese, and -0.36kg/m2 for morbidly obese women. After initiating HAART, 40% with normal pre-HAART BMI became overweight at some point; of those overweight, 46% remained overweight and 47% became obese; 71% of obese women remained obese and 27% became morbidly obese. Each year of nucleoside analog reverse transcriptase inhibitor use was associated with a 3% decreased odds of reaching a higher BMI category (OR 0.97, 95% CI: 0.95, 0.99), while each year of protease inhibitor or non-nucleoside analog reverse transcriptase inhibitor use were associated with a 6% (OR 1.06, 95% CI: 1.04, 1.08) and 5%(OR 1.05, 95% CI: 1.01, 1.08) increased odds of having a higher BMI category, respectively. Conclusions: Although overweight and obesity are highly prevalent in this large cohort of HIV-infected, minority women, HAART use was associated with only a modest increase in BMI over time.

Original languageEnglish (US)
Pages (from-to)2-8
Number of pages7
JournalJournal of AIDS and Clinical Research
Volume5
Issue number7
DOIs
StatePublished - 2014

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Highly Active Antiretroviral Therapy
Body Mass Index
HIV
Confidence Intervals
Reverse Transcriptase Inhibitors
Thinness
Protease Inhibitors
Nucleosides
Obesity
Logistic Models

Keywords

  • Body mass index
  • HAART
  • HIV
  • Obesity
  • Women
  • Women’s interagency HIV study

ASJC Scopus subject areas

  • Infectious Diseases
  • Dermatology
  • Immunology
  • Virology

Cite this

Changes in body mass index following HAART initiation among HIVinfected women in the women’s interagency HIV study. / Sharma, Anjali; Bynum, Shalanda A.; Schneider, Michael F.; Cox, Christopher; Tien, Phyllis C.; Hershow, Ronald C.; Gustafson, Deborah; Plankey, Michael W.

In: Journal of AIDS and Clinical Research, Vol. 5, No. 7, 2014, p. 2-8.

Research output: Contribution to journalArticle

Sharma, Anjali ; Bynum, Shalanda A. ; Schneider, Michael F. ; Cox, Christopher ; Tien, Phyllis C. ; Hershow, Ronald C. ; Gustafson, Deborah ; Plankey, Michael W. / Changes in body mass index following HAART initiation among HIVinfected women in the women’s interagency HIV study. In: Journal of AIDS and Clinical Research. 2014 ; Vol. 5, No. 7. pp. 2-8.
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AU - Sharma, Anjali

AU - Bynum, Shalanda A.

AU - Schneider, Michael F.

AU - Cox, Christopher

AU - Tien, Phyllis C.

AU - Hershow, Ronald C.

AU - Gustafson, Deborah

AU - Plankey, Michael W.

PY - 2014

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N2 - Objective: Examine changes in, and factors associated with changing body mass index (BMI) in women following highly active antiretroviral therapy (HAART) initiation. Methods: 1177 HIV-infected Women’s Interagency HIV Study participants who contributed 10,754 years of followup following HAART initiation were studied. Changes in median BMI up to 15 years following HAART initiation, and the highest and lowest BMI reached following HAART initiation were summarized by pre-HAART BMI category (<18.5 [underweight], 18.5-<25.0 [normal weight], 25.0-<30.0 [overweight], 30.0-<40.0 [obese], and ≥ 40.0 [morbidly obese]). Multivariate mixed effects ordinal logistic regression estimated the degree of association of each exposure of interest with post-HAART BMI. Results: Before HAART, 39% percent of women had normal BMI, 31% were overweight, 23% were obese, and 5% were morbidly obese. Following HAART initiation, median BMI change (per 5 years) was 0.21 kg/m2 (90% confidence interval [CI]: -1.33, 0.42) for those with normal pre-HAART BMI, 0.39 kg/m2 (90% CI: 0.15,0.66) for overweight, 0.31 kg/ m2 (90% CI: -1.18,0.67) for obese, and -0.36kg/m2 for morbidly obese women. After initiating HAART, 40% with normal pre-HAART BMI became overweight at some point; of those overweight, 46% remained overweight and 47% became obese; 71% of obese women remained obese and 27% became morbidly obese. Each year of nucleoside analog reverse transcriptase inhibitor use was associated with a 3% decreased odds of reaching a higher BMI category (OR 0.97, 95% CI: 0.95, 0.99), while each year of protease inhibitor or non-nucleoside analog reverse transcriptase inhibitor use were associated with a 6% (OR 1.06, 95% CI: 1.04, 1.08) and 5%(OR 1.05, 95% CI: 1.01, 1.08) increased odds of having a higher BMI category, respectively. Conclusions: Although overweight and obesity are highly prevalent in this large cohort of HIV-infected, minority women, HAART use was associated with only a modest increase in BMI over time.

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