Rising Obesity Prevalence and Weight Gain Among Adults Starting Antiretroviral Therapy in the United States and Canada

Details

• Alternative Title:
  AIDS Res Hum Retroviruses
• Personal Author:
  Koethe, John R. ; Jenkins, Cathy A. ; Lau, Bryan ; Shepherd, Bryan E. ; Justice, Amy C. ; Tate, Janet P. ; Buchacz, Kate ; Napravnik, Sonia ; Mayor, Angel M. ; Horberg, Michael A. ; Blashill, Aaron J. ; Willig, Amanda ; Wester, C. William ; Silverberg, Michael J. ; Gill, John ; Thorne, Jennifer E. ; Klein, Marina ; Eron, Joseph J. ; Kitahata, Mari M. ; Sterling, Timothy R. ; Moore, Richard D.
• Corporate Authors:
  for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)
• 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.
• Subjects:
  Adult Anti-HIV Agents Antiretroviral Therapy, Highly Active Black People Body Mass Index CD4 Lymphocyte Count Cohort Studies Female HIV-1 HIV Infections Humans Male Middle Aged Nutrition Surveys Obesity Prevalence Risk Factors Weight Gain White People

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• Source:
  AIDS Res Hum Retroviruses. 32(1):50-58
• Pubmed ID:
  26352511
• Pubmed Central ID:
  PMC4692122
• Document Type:
  Journal Article
• Funding:
  U01-AI34989/AI/NIAID NIH HHSUnited States/ ; U01-AI38855/AI/NIAID NIH HHSUnited States/ ; R01-AA16893/AA/NIAAA NIH HHSUnited States/ ; R24-AI067039/AI/NIAID NIH HHSUnited States/ ; U01-HD32632/HD/NICHD NIH HHSUnited States/ ; U24 AA022001/AA/NIAAA NIH HHSUnited States/ ; U01-AI34993/AI/NIAID NIH HHSUnited States/ ; P30-MH62246/MH/NIMH NIH HHSUnited States/ ; R56-AI102622/AI/NIAID NIH HHSUnited States/ ; U01-AI35043/AI/NIAID NIH HHSUnited States/ ; HCP-97105/Canadian Institutes of Health ResearchCanada/ ; P30 AI094189/AI/NIAID NIH HHSUnited States/ ; U01-AI38858/AI/NIAID NIH HHSUnited States/ ; G12 MD007583/MD/NIMHD NIH HHSUnited States/ ; R01-DA04334/DA/NIDA NIH HHSUnited States/ ; U01-AI35040/AI/NIAID NIH HHSUnited States/ ; U54 MD007587/MD/NIMHD NIH HHSUnited States/ ; U01-AI37984/AI/NIAID NIH HHSUnited States/ ; K23 AI100700/AI/NIAID NIH HHSUnited States/ ; U01-AI35004/AI/NIAID NIH HHSUnited States/ ; U01-AI68636/AI/NIAID NIH HHSUnited States/ ; UL1-RR024975-01/RR/NCRR NIH HHSUnited States/ ; P30-AI036219/AI/NIAID NIH HHSUnited States/ ; U01-AI68634/AI/NIAID NIH HHSUnited States/ ; U01-AI69432/AI/NIAID NIH HHSUnited States/ ; P30-AI094189/AI/NIAID NIH HHSUnited States/ ; U01-AI35042/AI/NIAID NIH HHSUnited States/ ; U54-MD007587/MD/NIMHD NIH HHSUnited States/ ; U01-AI37613/AI/NIAID NIH HHSUnited States/ ; K23-100700/PHS HHSUnited States/ ; M01-RR-00052/RR/NCRR NIH HHSUnited States/ ; U01-AI069918/AI/NIAID NIH HHSUnited States/ ; UM1 AI035043/AI/NIAID NIH HHSUnited States/ ; U01-AI42590/AI/NIAID NIH HHSUnited States/ ; P30-AI50410/AI/NIAID NIH HHSUnited States/ ; KRS-86251/Canadian Institutes of Health ResearchCanada/ ; AI54999/AI/NIAID NIH HHSUnited States/ ; CBR-86906/Canadian Institutes of Health ResearchCanada/ ; UL1-RR024131/RR/NCRR NIH HHSUnited States/ ; R01-DA12568/DA/NIDA NIH HHSUnited States/ ; U01-AI31834/AI/NIAID NIH HHSUnited States/ ; U01-AI69434/AI/NIAID NIH HHSUnited States/ ; K23-MH096647/MH/NIMH NIH HHSUnited States/ ; CC999999/Intramural CDC HHSUnited States/ ; K24-DA00432/DA/NIDA NIH HHSUnited States/ ; P30-AI27757/AI/NIAID NIH HHSUnited States/ ; U01 AA020790/AA/NIAAA NIH HHSUnited States/ ; P30 AI027763/AI/NIAID NIH HHSUnited States/ ; CBR-94036/Canadian Institutes of Health ResearchCanada/ ; UL1-TR000083/TR/NCATS NIH HHSUnited States/ ; U01-AI35041/AI/NIAID NIH HHSUnited States/ ; 90047713/PHS HHSUnited States/ ; KL2 TR002317/TR/NCATS NIH HHSUnited States/ ; U01-AI35039/AI/NIAID NIH HHSUnited States/ ; N02-CP55504/CP/NCI NIH HHSUnited States/ ; P30-AI27767/AI/NIAID NIH HHSUnited States/ ; K24-AI65298/AI/NIAID NIH HHSUnited States/ ; TGF-96118/Canadian Institutes of Health ResearchCanada/ ; D43 TW000010/TW/FIC NIH HHSUnited States/ ; R01-DA11602/DA/NIDA NIH HHSUnited States/ ; U01-DA036935/DA/NIDA NIH HHSUnited States/ ; 290-2011-00007C/PHS HHSUnited States/ ; G12-MD007583/MD/NIMHD NIH HHSUnited States/ ; CDC200-2011-41872/PHS HHSUnited States/ ; U01-AI34994/AI/NIAID NIH HHSUnited States/ ; 90051652/PHS HHSUnited States/ ; P30 AI036219/AI/NIAID NIH HHSUnited States/ ; KL2 TR000421/TR/NCATS NIH HHSUnited States/ ; U24 AA020794/AA/NIAAA NIH HHSUnited States/ ; P30-AI027763/AI/NIAID NIH HHSUnited States/ ; 250-2012-00008C/PHS HHSUnited States/ ; P30 AI050410/AI/NIAID NIH HHSUnited States/ ; U01 AI042590/AI/NIAID NIH HHSUnited States/
• Place as Subject:
  Canada ; United States
• Volume:
  32
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5ce564dff1c5f44245ab2c05cf78cb3d3fac8514153d17d71f04ba7b4dab1bb0
• Download URL:
  https://stacks.cdc.gov/view/cdc/37099/cdc_37099_DS1.pdf
• File Type:
  [PDF - 1.39 MB ]