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. 2014:5:1000323.
doi: 10.4172/2155-6113.1000323.

Changes in Body Mass Index Following HAART Initiation among HIV-Infected Women in the Women's Interagency HIV Study

Anjali Sharma  1 , Shalanda A Bynum  2 , Michael F Schneider  3 , Christopher Cox  3 , Phyllis C Tien  4 , Ronald C Hershow  5 , Deborah Gustafson  6 , Michael W Plankey  7
Affiliations

Changes in Body Mass Index Following HAART Initiation among HIV-Infected Women in the Women's Interagency HIV Study

Anjali Sharma et al. J AIDS Clin Res. 2014.

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 follow-up 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.

Keywords: Body mass index; HAART; HIV; Obesity; Women; Women's interagency HIV study.

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Figures

Figure 1
Figure 1
Box-percentile plot of mean pre-highly active antiretroviral therapy (HAART) initiation body mass index (BMI) values taken up to five years prior to HAART initiation. The central 95% of the distribution of values are shown. The minimum BMI was 15.2 kg/m2 and the maximum BMI was 70.6 kg/m2.
Figure 2
Figure 2
Median and inter-quartile range of body mass index (BMI) at each visit after HAART initiation stratified by pre-HAART initiation BMI category.
See this image and copyright information in PMC

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