Obesity Trends and Body Mass Index Changes After Starting Antiretroviral Treatment: The Swiss HIV Cohort Study

Hasse, B.; Iff, M.; Ledergerber, B.; Calmy, A.; Schmid, P.; Hauser, Christoph; Cavassini, M.; Bernasconi, E.; Marzolini, C.; Tarr, P. E.; Swiss HIV, Cohort Study; Furrer, Hansjakob; Gorgievski, Meri; Rauch, Andri; Stähelin, Cornelia Johanna (2014). Obesity Trends and Body Mass Index Changes After Starting Antiretroviral Treatment: The Swiss HIV Cohort Study. Open Forum Infectious Diseases, 1(2), ofu040. Oxford University Press 10.1093/ofid/ofu040

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BACKGROUND The factors that contribute to increasing obesity rates in human immunodeficiency virus (HIV)-positive persons and to body mass index (BMI) increase that typically occurs after starting antiretroviral therapy (ART) are incompletely characterized. METHODS We describe BMI trends in the entire Swiss HIV Cohort Study (SHCS) population and investigate the effects of demographics, HIV-related factors, and ART on BMI change in participants with data available before and 4 years after first starting ART. RESULTS In the SHCS, overweight/obesity prevalence increased from 13% in 1990 (n = 1641) to 38% in 2012 (n = 8150). In the participants starting ART (n = 1601), mean BMI increase was 0.92 kg/m(2) per year (95% confidence interval, .83-1.0) during year 0-1 and 0.31 kg/m(2) per year (0.29-0.34) during years 1-4. In multivariable analyses, annualized BMI change during year 0-1 was associated with older age (0.15 [0.06-0.24] kg/m(2)) and CD4 nadir <199 cells/µL compared to nadir >350 (P < .001). Annualized BMI change during years 1-4 was associated with CD4 nadir <100 cells/µL compared to nadir >350 (P = .001) and black compared to white ethnicity (0.28 [0.16-0.37] kg/m(2)). Individual ART combinations differed little in their contribution to BMI change. CONCLUSIONS Increasing obesity rates in the SHCS over time occurred at the same time as aging of the SHCS population, demographic changes, earlier ART start, and increasingly widespread ART coverage. Body mass index increase after ART start was typically biphasic, the BMI increase in year 0-1 being as large as the increase in years 1-4 combined. The effect of ART regimen on BMI change was limited.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Hauser, Christoph; Furrer, Hansjakob; Gorgievski, Meri; Rauch, Andri and Stähelin, Cornelia Johanna

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

2328-8957

Publisher:

Oxford University Press

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

18 Feb 2015 11:35

Last Modified:

26 Jun 2016 01:58

Publisher DOI:

10.1093/ofid/ofu040

PubMed ID:

25734114

Additional Information:

Swiss HIV Cohort Study: nur Berner Mitarbeitende namentlich erwähnt

BORIS DOI:

10.7892/boris.62798

URI:

https://boris.unibe.ch/id/eprint/62798

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