Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 23;25(1):1523.
doi: 10.4102/sajhivmed.v25i1.1523. eCollection 2024.

Trends in body mass index in the pre-dolutegravir period in South Africa

Florian van Ginkel  1 , Roos E Barth  2 , Hugo Tempelman  3 , Kerstin Klipstein-Grobusch  1   4 , Diederick E Grobbee  1 , Karine Scheuermaier  1   5 , Francois W D Venter  6 , Alinda G Vos-Seda  1   6
Affiliations

Trends in body mass index in the pre-dolutegravir period in South Africa

Florian van Ginkel et al. South Afr J HIV Med. .

Abstract

Background: Antiretroviral therapy (ART) is associated with weight gain, but this has been shown to be more marked with dolutegravir and other integrase strand transfer inhibitors.

Objectives: We studied weight gain in people living with HIV (PLWH) on ART compared to the general population in the period before dolutegravir was introduced in a rural South African cohort.

Method: Longitudinal analysis of the Ndlovu Cohort Study including 36-48 months' follow-up data. From 2014 to 2019, data were collected annually in Limpopo, rural South Africa. Linear mixed models using HIV status, demographics, ART use and cardiovascular risk factors were used to estimate trends in body mass index (BMI) over time.

Results: In total, 1518 adult, non-pregnant participants were included, of whom 518 were PLWH on ART (79.8%), 135 PLWH not yet on ART (20.2%) and 865 HIV-negative. HIV-negative participants had significantly higher BMIs than PLWH on ART at all study visits. There was a significant increase in BMI in all subgroups after 36 months (PLWH on ART, BMI +1.2 kg/m2, P < 0.001; PLWH not on ART, BMI +1.8 kg/m2, P < 0.001 and HIV-negative, BMI +1.3 kg/m2, P < 0.001).

Conclusion: The increase in BMI in PLWH and HIV-negative participants is a serious warning signal as obesity results in morbidity and mortality.

Keywords: HIV; antiretroviral therapy; body mass index; integrase strand transfer inhibitors; obesity; sub-Saharan Africa.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Body mass index over time in the Ndlovu Cohort Study.
FIGURE 2
FIGURE 2
Relative percentages of body mass index categorised at baseline and after 48 months of study follow up in Ndlovu Cohort Study. (a) Baseline (N = 1518); (b) 12 months (N = 1372); (c) 24 months (N = 1178); (d) 36 months (N = 1128) and (e) 48 months (N = 566).
FIGURE 3
FIGURE 3
Body mass index over time by self-reported antiretroviral therapy (model 1).
FIGURE 1-A1
FIGURE 1-A1
Body mass index over time by viral load suppression as proxy for antiretroviral therapy (model 2).
FIGURE 2-A1
FIGURE 2-A1
Body mass index over time stratified by fixed groups (model 3).
See this image and copyright information in PMC

References

    1. Afshin A, Forouzanfar MH, Reitsma MB, et al. . Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377(1):13–27. 10.1056/NEJMoa1614362 - DOI - PMC - PubMed
    1. Di Angelantonio E, Bhupathiraju SN, Wormser D, et al. . Body-mass index and all-cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388(10046):776–786. 10.1016/S0140-6736(16)30175-1 - DOI - PMC - PubMed
    1. Kivimäki M, Kuosma E, Ferrie JE, et al. . Overweight, obesity, and risk of cardiometabolic multimorbidity: Pooled analysis of individual-level data for 120 813 adults from 16 cohort studies from the USA and Europe. Lancet Public Health. 2017;2(6):e277–e285. 10.1016/S2468-2667(17)30074-9 - DOI - PMC - PubMed
    1. Hamid S, Groot W, Pavlova M. Trends in cardiovascular diseases and associated risks in sub-Saharan Africa: A review of the evidence for Ghana, Nigeria, South Africa, Sudan and Tanzania. Aging Male. 2019;22(3):169–176. 10.1080/13685538.2019.1582621 - DOI - PubMed
    1. Statistics South Africa . South Africa demographic and health survey 2016: Key indicator report. Statistics South Africa, 2017; p. 1–57.

LinkOut - more resources