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Weight changes, metabolic syndrome and all‐cause mortality among Asian adults living with HIV

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Názov: Weight changes, metabolic syndrome and all‐cause mortality among Asian adults living with HIV
Autori: Win Min Han, Matthew G. Law, Jun Yong Choi, Rossana Ditangco, Nagalingeswaran Kumarasamy, Romanee Chaiwarith, Penh Sun Ly, Suwimon Khusuwan, Tuti Parwati Merati, Cuong Duy Do, Evy Yunihastuti, Iskandar Azwa, Man‐Po Lee, Thach Ngoc Pham, Yu‐Jiun Chan, Sasisopin Kiertiburanakul, Oon Tek Ng, Junko Tanuma, Sanjay Pujari, Fujie Zhang, Yasmin Gani, Vidya Mave, Jeremy Ross, Anchalee Avihingsanon
Prispievatelia: Win Min Han, Matthew G Law, Jun Yong Choi, Rossana Ditangco, Nagalingeswaran Kumarasamy, Romanee Chaiwarith, Penh Sun Ly, Suwimon Khusuwan, Tuti Parwati Merati, Cuong Duy Do, Evy Yunihastuti, Iskandar Azwa, Man-Po Lee, Thach Ngoc Pham, Yu-Jiun Chan, Sasisopin Kiertiburanakul, Oon Tek Ng, Junko Tanuma, Sanjay Pujari, Fujie Zhang, Yasmin Gani, Vidya Mave, Jeremy Ross, Anchalee Avihingsanon, TREAT Asia HIV Observational Database of IeDEA Asia-Pacific, Choi, Jun Yong
Zdroj: HIV Medicine. 23:274-286
Informácie o vydavateľovi: Wiley, 2021.
Rok vydania: 2021
Predmety: HIV Infections* / drug therapy, Adult, Male, Metabolic Syndrome, Metabolic Syndrome* / complications, weight gain, HIV Infections, Reverse Transcriptase Inhibitors / therapeutic use, Metabolic Syndrome* / epidemiology, HIV Infections* / complications, metabolic syndrome, CD4 Lymphocyte Count, 3. Good health, Asian people living with HIV, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, HIV/AIDS, all-cause mortality, Humans, Reverse Transcriptase Inhibitors, Metabolic Syndrome* / drug therapy
Popis: ObjectivesWe investigated weight changes following antiretroviral therapy (ART) initiation, the development of metabolic syndrome (MetS) and its association with all‐cause mortality among Asian adults living with HIV.MethodsParticipants enrolled in a regional Asian HIV‐infected cohort with weight and height measurements at ART initiation were eligible for inclusion in the analysis. Factors associated with weight changes and incident MetS (according to the International Diabetic Federation (IDF) definition) were analysed using linear mixed models and Cox regression, respectively. Competing‐risk regression models were used to investigate the association of MetS with all‐cause mortality.ResultsAmong 4931 people living with HIV (PLWH), 66% were male. At ART initiation, the median age was 34 [interquartile range (IQR) 29–41] years, and the median (IQR) weight and body mass index (BMI) were 55 (48–63) kg and 20.5 (18.4–22.9) kg/m2, respectively. At 1, 2 and 3 years of ART, overall mean (± standard deviation) weight gain was 2.2 (±5.3), 3.0 (±6.2) and 3.7 (±6.5) kg, respectively. Participants with baseline CD4 count ≤ 200 cells/µL [weight difference (diff) = 2.2 kg; 95% confidence interval (CI) 1.9–2.5 kg] and baseline HIV RNA ≥ 100 000 HIV‐1 RNA copies/mL (diff = 0.6 kg; 95% CI 0.2–1.0 kg), and those starting with integrase strand transfer inhibitor (INSTI)‐based ART (diff = 2.1 kg; 95% CI 0.7–3.5 kg vs. nonnucleoside reverse transcriptase inhibitors) had greater weight gain. After exclusion of those with abnormal baseline levels of MetS components, 295/3503 had incident MetS [1.18 (95% CI 1.05–1.32)/100 person‐years (PY)]. The mortality rate was 0.7 (95% CI 0.6–0.8)/100 PY. MetS was not significantly associated with all‐cause mortality in the adjusted model (P = 0.236).ConclusionsWeight gain after ART initiation was significantly higher among those initiating ART with lower CD4 count, higher HIV RNA and an INSTI‐based regimen after controlling for baseline BMI. Greater efforts to identify and manage MetS among PLWH are needed.
Druh dokumentu: Article
Jazyk: English
ISSN: 1468-1293
1464-2662
DOI: 10.1111/hiv.13211
Prístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/34816562
https://onlinelibrary.wiley.com/doi/abs/10.1111/hiv.13211
https://pubmed.ncbi.nlm.nih.gov/34816562/
https://www.ncbi.nlm.nih.gov/pubmed/34816562
Rights: Wiley Online Library User Agreement
CC BY NC ND
Prístupové číslo: edsair.doi.dedup.....b5c0dff1727a17d8f74356134e47f1e1
Databáza: OpenAIRE
Popis
Abstrakt:ObjectivesWe investigated weight changes following antiretroviral therapy (ART) initiation, the development of metabolic syndrome (MetS) and its association with all‐cause mortality among Asian adults living with HIV.MethodsParticipants enrolled in a regional Asian HIV‐infected cohort with weight and height measurements at ART initiation were eligible for inclusion in the analysis. Factors associated with weight changes and incident MetS (according to the International Diabetic Federation (IDF) definition) were analysed using linear mixed models and Cox regression, respectively. Competing‐risk regression models were used to investigate the association of MetS with all‐cause mortality.ResultsAmong 4931 people living with HIV (PLWH), 66% were male. At ART initiation, the median age was 34 [interquartile range (IQR) 29–41] years, and the median (IQR) weight and body mass index (BMI) were 55 (48–63) kg and 20.5 (18.4–22.9) kg/m2, respectively. At 1, 2 and 3 years of ART, overall mean (± standard deviation) weight gain was 2.2 (±5.3), 3.0 (±6.2) and 3.7 (±6.5) kg, respectively. Participants with baseline CD4 count ≤ 200 cells/µL [weight difference (diff) = 2.2 kg; 95% confidence interval (CI) 1.9–2.5 kg] and baseline HIV RNA ≥ 100 000 HIV‐1 RNA copies/mL (diff = 0.6 kg; 95% CI 0.2–1.0 kg), and those starting with integrase strand transfer inhibitor (INSTI)‐based ART (diff = 2.1 kg; 95% CI 0.7–3.5 kg vs. nonnucleoside reverse transcriptase inhibitors) had greater weight gain. After exclusion of those with abnormal baseline levels of MetS components, 295/3503 had incident MetS [1.18 (95% CI 1.05–1.32)/100 person‐years (PY)]. The mortality rate was 0.7 (95% CI 0.6–0.8)/100 PY. MetS was not significantly associated with all‐cause mortality in the adjusted model (P = 0.236).ConclusionsWeight gain after ART initiation was significantly higher among those initiating ART with lower CD4 count, higher HIV RNA and an INSTI‐based regimen after controlling for baseline BMI. Greater efforts to identify and manage MetS among PLWH are needed.
ISSN:14681293
14642662
DOI:10.1111/hiv.13211