Changes in body mass index and clinical outcomes after initiation of contemporary antiretroviral regimens
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Changes in body mass index and clinical outcomes after initiation of contemporary antiretroviral regimens. / Bannister, Wendy P.; Mast, T. Christopher; De Wit, Stéphane; Gerstoft, Jan; Wiese, Lothar; Milinkovic, Ana; Hadziosmanovic, Vesna; Clarke, Amanda; Rasmussen, Line D.; Lacombe, Karine; Schommers, Philipp; Staub, Thérèse; Zagalo, Alexandra; Portu, Joseba J.; Tau, Luba; Calmy, Alexandra; Cavassini, Matthias; Gisinger, Martin; Borodulina, Elena; Mocroft, Amanda; Reekie, Joanne; Peters, Lars; for the EuroSIDA study group.
In: AIDS, Vol. 36, No. 15, 2022, p. 2107-2119.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Changes in body mass index and clinical outcomes after initiation of contemporary antiretroviral regimens
AU - Bannister, Wendy P.
AU - Mast, T. Christopher
AU - De Wit, Stéphane
AU - Gerstoft, Jan
AU - Wiese, Lothar
AU - Milinkovic, Ana
AU - Hadziosmanovic, Vesna
AU - Clarke, Amanda
AU - Rasmussen, Line D.
AU - Lacombe, Karine
AU - Schommers, Philipp
AU - Staub, Thérèse
AU - Zagalo, Alexandra
AU - Portu, Joseba J.
AU - Tau, Luba
AU - Calmy, Alexandra
AU - Cavassini, Matthias
AU - Gisinger, Martin
AU - Borodulina, Elena
AU - Mocroft, Amanda
AU - Reekie, Joanne
AU - Peters, Lars
AU - for the EuroSIDA study group
N1 - Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Background:Weight gain is becoming increasingly prevalent amongst people with HIV (PWH) receiving contemporary antiretroviral treatment. We investigated BMI changes and clinical impact in a large prospective observational study.Methods:PWH aged ≥18 years were included who started a new antiretroviral (baseline) during 2010-2019 with baseline and ≥1 follow-up BMI assessment available. Rates of clinical outcomes (cardiovascular disease [CVD], malignancies, diabetes mellitus [DM] and all-cause mortality) were analysed using Poisson regression to assess effect of time-updated BMI changes (>1 kg/m2decrease, ±1 kg/m2stable, >1 kg/m2increase), lagged by 1-year to reduce reverse causality. Analyses were adjusted for baseline BMI plus key confounders including antiretroviral exposure.Results:6721 PWH were included; 72.3% were male, median age 48 years (interquartile range [IQR] 40-55). At baseline, 8.4% were antiretroviral-naive, and 5.0% were underweight, 59.7% healthy weight, 27.5% overweight, and 7.8% were living with obesity. There was an 8.2% increase in proportion of overweight and 4.8% in obesity over the study period (median follow-up 4.4 years [IQR 2.6-6.7]).100 CVDs, 149 malignancies, 144 DMs, and 257 deaths were observed with incidence rates 4.4, 6.8, 6.6, 10.6 per 1000 person-years of follow-up, respectively. Compared to stable BMI, >1 kg/m2increase was associated with increased risk of DM (adjusted incidence rate ratio [IRR]: 1.96, 95% confidence interval [CI]: 1.36-2.80) and >1 kg/m2decrease with increased risk of death (adjusted IRR: 2.33, 95% CI: 1.73-3.13). No significant associations were observed between BMI changes and CVD or malignancies.Conclusions:A BMI increase was associated with DM and a decrease associated with death.
AB - Background:Weight gain is becoming increasingly prevalent amongst people with HIV (PWH) receiving contemporary antiretroviral treatment. We investigated BMI changes and clinical impact in a large prospective observational study.Methods:PWH aged ≥18 years were included who started a new antiretroviral (baseline) during 2010-2019 with baseline and ≥1 follow-up BMI assessment available. Rates of clinical outcomes (cardiovascular disease [CVD], malignancies, diabetes mellitus [DM] and all-cause mortality) were analysed using Poisson regression to assess effect of time-updated BMI changes (>1 kg/m2decrease, ±1 kg/m2stable, >1 kg/m2increase), lagged by 1-year to reduce reverse causality. Analyses were adjusted for baseline BMI plus key confounders including antiretroviral exposure.Results:6721 PWH were included; 72.3% were male, median age 48 years (interquartile range [IQR] 40-55). At baseline, 8.4% were antiretroviral-naive, and 5.0% were underweight, 59.7% healthy weight, 27.5% overweight, and 7.8% were living with obesity. There was an 8.2% increase in proportion of overweight and 4.8% in obesity over the study period (median follow-up 4.4 years [IQR 2.6-6.7]).100 CVDs, 149 malignancies, 144 DMs, and 257 deaths were observed with incidence rates 4.4, 6.8, 6.6, 10.6 per 1000 person-years of follow-up, respectively. Compared to stable BMI, >1 kg/m2increase was associated with increased risk of DM (adjusted incidence rate ratio [IRR]: 1.96, 95% confidence interval [CI]: 1.36-2.80) and >1 kg/m2decrease with increased risk of death (adjusted IRR: 2.33, 95% CI: 1.73-3.13). No significant associations were observed between BMI changes and CVD or malignancies.Conclusions:A BMI increase was associated with DM and a decrease associated with death.
KW - antiretroviral therapy
KW - body mass index
KW - cardiovascular disease
KW - diabetes mellitus
KW - malignancy
KW - mortality
U2 - 10.1097/QAD.0000000000003332
DO - 10.1097/QAD.0000000000003332
M3 - Journal article
C2 - 35848573
AN - SCOPUS:85142400554
VL - 36
SP - 2107
EP - 2119
JO - AIDS
JF - AIDS
SN - 1350-2840
IS - 15
ER -
ID: 334992817