TY - JOUR
T1 - Inflammation and Change in Body Weight with Antiretroviral Therapy Initiation in a Multinational Cohort of HIV-Infected Adults
AU - Mave, Vidya
AU - Erlandson, Kristine M.
AU - Gupte, Nikhil
AU - Balagopal, Ashwin
AU - Asmuth, David M.
AU - Campbell, Thomas B.
AU - Smeaton, Laura
AU - Kumarasamy, Nagalingeswaran
AU - Hakim, James
AU - Santos, Breno
AU - Riviere, Cynthia
AU - Hosseinipour, Mina C.
AU - Sugandhavesa, Patcharaphan
AU - Infante, Rosa
AU - Pillay, Sandy
AU - Cardoso, Sandra W.
AU - Tripathy, Srikanth
AU - Mwelase, Noluthando
AU - Berendes, Sima
AU - Andrade, Bruno B.
AU - Thomas, David L.
AU - Bollinger, Robert C.
AU - Gupta, Amita
N1 - Publisher Copyright:
© 2016 The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background. Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation during human immunodeficiency virus infection is unknown. Methods. Among a random virologically suppressed participants of the Prospective Evaluation of Antiretrovirals in Resource-Limited Settings trial, inflammatory markers were measured at weeks 0, 24, and 48 after antiretroviral therapy (ART) initiation. Associations between both baseline and change in body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) and changes in inflammation markers were assessed using random effects models. Results. Of 246 participants, 27% were overweight/obese (BMI, ≥ 25), and 8% were underweight (BMI < 18.5) at baseline. After 48 weeks, 37% were overweight/obese, and 3% were underweight. While level of many inflammatory markers decreased 48 weeks after ART initiation in the overall group, the decrease in C-reactive protein (CRP) level was smaller in overweight/obese participants (P =. 01), and the decreases in both CRP (P =. 01) and interleukin 18 (P =. 02) levels were smaller in underweight participants. Each 1-unit gain in BMI among overweight/obese participants was associated with a 0.02-log10 increase in soluble CD14 level (P =. 05), while each 1-unit BMI gain among underweight participants was associated with a 9.32-mg/L decrease in CRP level (P =. 001). Conclusions. Being either overweight or underweight at ART initiation was associated with heightened systemic inflammation. While weight gain among overweight/obese persons predicted increased inflammation, weight gain among underweight persons predicted reduced inflammation.
AB - Background. Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation during human immunodeficiency virus infection is unknown. Methods. Among a random virologically suppressed participants of the Prospective Evaluation of Antiretrovirals in Resource-Limited Settings trial, inflammatory markers were measured at weeks 0, 24, and 48 after antiretroviral therapy (ART) initiation. Associations between both baseline and change in body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) and changes in inflammation markers were assessed using random effects models. Results. Of 246 participants, 27% were overweight/obese (BMI, ≥ 25), and 8% were underweight (BMI < 18.5) at baseline. After 48 weeks, 37% were overweight/obese, and 3% were underweight. While level of many inflammatory markers decreased 48 weeks after ART initiation in the overall group, the decrease in C-reactive protein (CRP) level was smaller in overweight/obese participants (P =. 01), and the decreases in both CRP (P =. 01) and interleukin 18 (P =. 02) levels were smaller in underweight participants. Each 1-unit gain in BMI among overweight/obese participants was associated with a 0.02-log10 increase in soluble CD14 level (P =. 05), while each 1-unit BMI gain among underweight participants was associated with a 9.32-mg/L decrease in CRP level (P =. 001). Conclusions. Being either overweight or underweight at ART initiation was associated with heightened systemic inflammation. While weight gain among overweight/obese persons predicted increased inflammation, weight gain among underweight persons predicted reduced inflammation.
KW - HAART clinical outcomes
KW - HIV/AIDS
KW - body mass index
KW - immune activation/inflammation
KW - noncommunicable diseases
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U2 - 10.1093/infdis/jiw096
DO - 10.1093/infdis/jiw096
M3 - Article
C2 - 26962236
AN - SCOPUS:84979208004
SN - 0022-1899
VL - 214
SP - 65
EP - 72
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 1
ER -