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. 2019 May 2;19(1):373.
doi: 10.1186/s12879-019-3991-6.

Predictive effects of body mass index on immune reconstitution among HIV-infected HAART users in China

Xiaolin Li  1   2   3   4 , Haibo Ding  1   2   3   4 , Wenqing Geng  1   2   3   4 , Jing Liu  1   2   3   4 , Yongjun Jiang  1   2   3   4 , Junjie Xu  1   2   3   4 , Zining Zhang  1   2   3   4 , Hong Shang  5   6   7   8
Affiliations

Predictive effects of body mass index on immune reconstitution among HIV-infected HAART users in China

Xiaolin Li et al. BMC Infect Dis. .

Abstract

Background: Body mass index (BMI) may contribute somewhat to drug metabolism, and thus affecting the efficacy of highly active antiretroviral therapy (HAART). This study aimed to determine the frequencies of underweight, normal and overweight/obesity at pre-HAART in a large cohort of HIV-infected Chinese patients, and investigate the prospective effects of BMI on immune reconstitution after HAART initiation.

Methods: A longitudinal cohort study was performed to analyze the effects of BMI on immune reconstitution in HIV-infected patients treated with HAART. Multiple linear regression was used to evaluate the relationship between baseline BMI and increased CD4+ T lymphocyte levels at 12 and 30 months after initiating HAART. In addition, Cox proportional hazard model was used to assess the relationship between BMI and time to achieve immunologic reconstitution (CD4+ T lymphocytes>500cells/μL) during the follow-up period.

Results: Among the 1612 enrolled patients, 283 (17.6%) were overweight/obese (BMI ≥ 25 kg/m2), 173 (10.7%) were underweight (BMI < 18.5 kg/m2) and the remaining were normal weight. Prior to HAART initiating, overweight HIV-infected patients were mostly males, older ages, exhibited higher CD4+ T lymphocytes and lower viral loads (p < 0.01 for all). Patients with higher baseline BMI had an independently positive effect on 30-month CD4+ T lymphocyte recovery (p = 0.028), but not 12-month CD4+ T lymphocyte gain (p = 0.104). In addition, a Cox proportional hazard model with baseline BMI as an independent variable indicated that BMI was correlated with an increased likelihood of achieving immunologic reconstitution over time (hazard ratios [HR] 1.03; 95% confidence intervals [CI] 1.01-1.06; p = 0.011), after adjusting for baseline age, gender, CD4+ T lymphocytes, CD4/CD8 ratio, viral load and WHO stage.

Conclusions: Higher baseline BMI could predict better immune reconstitution in HIV-infected patients after HAART initiating.

Keywords: Antiretroviral therapy; Body mass index; China; HIV; Immune reconstitution.

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Conflict of interest statement

Authors’ information

Xiaolin Li, Haibo Ding, and Jing Liu mainly engage in the treatment and management of HIV-infected patients; Zining Zhang, Wenqing Geng, Yongjun Jiang and Hong Shang have an in-depth study on the immunology and virology of AIDS; Junjie Xu is engaged in epidemiological survey of AIDS.

Ethics approval and consent to participate

This study was approved by Ethics Committee of The First Affiliated Hospital of China Medical University. All participants signed informed consent statements.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Mean CD4+ T lymphocytes and CD4/CD8 ratio over time on HAART stratified by body mass index
See this image and copyright information in PMC

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