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Rising Obesity Prevalence and Weight Gain Among Adults Starting Antiretroviral Therapy in the United States and Canada
Filetype[PDF - 1.39 MB]


Details:
  • Corporate Authors:
    for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)
  • Pubmed ID:
    26352511
  • Pubmed Central ID:
    PMC4692122
  • Funding:
    250-2012-00008C/PHS HHS/United States
    290-2011-00007C/PHS HHS/United States
    90047713/PHS HHS/United States
    90051652/PHS HHS/United States
    AI54999/AI/NIAID NIH HHS/United States
    CBR-86906/Canadian Institutes of Health Research/Canada
    CBR-94036/Canadian Institutes of Health Research/Canada
    CC999999/Intramural CDC HHS/United States
    CDC200-2011-41872/PHS HHS/United States
    D43 TW000010/TW/FIC NIH HHS/United States
    G12 MD007583/MD/NIMHD NIH HHS/United States
    G12-MD007583/MD/NIMHD NIH HHS/United States
    HCP-97105/Canadian Institutes of Health Research/Canada
    K23 AI100700/AI/NIAID NIH HHS/United States
    K23-100700/PHS HHS/United States
    K23-MH096647/MH/NIMH NIH HHS/United States
    K24-AI65298/AI/NIAID NIH HHS/United States
    K24-DA00432/DA/NIDA NIH HHS/United States
    KL2 TR000421/TR/NCATS NIH HHS/United States
    KRS-86251/Canadian Institutes of Health Research/Canada
    M01-RR-00052/RR/NCRR NIH HHS/United States
    N02-CP55504/CP/NCI NIH HHS/United States
    P30 AI027763/AI/NIAID NIH HHS/United States
    P30 AI050410/AI/NIAID NIH HHS/United States
    P30 AI094189/AI/NIAID NIH HHS/United States
    P30-AI027763/AI/NIAID NIH HHS/United States
    P30-AI036219/AI/NIAID NIH HHS/United States
    P30-AI094189/AI/NIAID NIH HHS/United States
    P30-AI27757/AI/NIAID NIH HHS/United States
    P30-AI27767/AI/NIAID NIH HHS/United States
    P30-AI50410/AI/NIAID NIH HHS/United States
    P30-MH62246/MH/NIMH NIH HHS/United States
    R01-AA16893/AA/NIAAA NIH HHS/United States
    R01-DA04334/DA/NIDA NIH HHS/United States
    R01-DA11602/DA/NIDA NIH HHS/United States
    R01-DA12568/DA/NIDA NIH HHS/United States
    R24-AI067039/AI/NIAID NIH HHS/United States
    R56-AI102622/AI/NIAID NIH HHS/United States
    TGF-96118/Canadian Institutes of Health Research/Canada
    U01-AI069918/AI/NIAID NIH HHS/United States
    U01-AI31834/AI/NIAID NIH HHS/United States
    U01-AI34989/AI/NIAID NIH HHS/United States
    U01-AI34993/AI/NIAID NIH HHS/United States
    U01-AI34994/AI/NIAID NIH HHS/United States
    U01-AI35004/AI/NIAID NIH HHS/United States
    U01-AI35039/AI/NIAID NIH HHS/United States
    U01-AI35040/AI/NIAID NIH HHS/United States
    U01-AI35041/AI/NIAID NIH HHS/United States
    U01-AI35042/AI/NIAID NIH HHS/United States
    U01-AI35043/AI/NIAID NIH HHS/United States
    U01-AI37613/AI/NIAID NIH HHS/United States
    U01-AI37984/AI/NIAID NIH HHS/United States
    U01-AI38855/AI/NIAID NIH HHS/United States
    U01-AI38858/AI/NIAID NIH HHS/United States
    U01-AI42590/AI/NIAID NIH HHS/United States
    U01-AI68634/AI/NIAID NIH HHS/United States
    U01-AI68636/AI/NIAID NIH HHS/United States
    U01-AI69432/AI/NIAID NIH HHS/United States
    U01-AI69434/AI/NIAID NIH HHS/United States
    U01-DA036935/DA/NIDA NIH HHS/United States
    U01-HD32632/HD/NICHD NIH HHS/United States
    U54-MD007587/MD/NIMHD NIH HHS/United States
    UL1-RR024131/RR/NCRR NIH HHS/United States
    UL1-RR024975-01/RR/NCRR NIH HHS/United States
    UL1-TR000083/TR/NCATS NIH HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    The proportion of overweight and obese adults in the United States and Canada has increased over the past decade, but temporal trends in body mass index (BMI) and weight gain on antiretroviral therapy (ART) among HIV-infected adults have not been well characterized. We conducted a cohort study comparing HIV-infected adults in the North America AIDS Cohort Collaboration on Research and Design (NA-ACCORD) to United States National Health and Nutrition Examination Survey (NHANES) controls matched by sex, race, and age over the period 1998 to 2010. Multivariable linear regression assessed the relationship between BMI and year of ART initiation, adjusting for sex, race, age, and baseline CD4(+) count. Temporal trends in weight on ART were assessed using a generalized least-squares model further adjusted for HIV-1 RNA and first ART regimen class. A total of 14,084 patients from 17 cohorts contributed data; 83% were male, 57% were nonwhite, and the median age was 40 years. Median BMI at ART initiation increased from 23.8 to 24.8 kg/m(2) between 1998 and 2010 in NA-ACCORD, but the percentage of those obese (BMI ≥30 kg/m(2)) at ART initiation increased from 9% to 18%. After 3 years of ART, 22% of individuals with a normal BMI (18.5-24.9 kg/m(2)) at baseline had become overweight (BMI 25.0-29.9 kg/m(2)), and 18% of those overweight at baseline had become obese. HIV-infected white women had a higher BMI after 3 years of ART as compared to age-matched white women in NHANES (p = 0.02), while no difference in BMI after 3 years of ART was observed for HIV-infected men or non-white women compared to controls. The high prevalence of obesity we observed among ART-exposed HIV-infected adults in North America may contribute to health complications in the future.