Changes in weight and weight distribution across the lifespan among HIV-infected and -uninfected men and women. Issue 46 (November 2016)

• Record Type: Journal Article
• Authors: Erlandson, Kristine M.; Zhang, Long; Lake, Jordan E.; Schrack, Jennifer; Althoff, Keri; Sharma, Anjali; Tien, Phyllis C.; Margolick, Joseph B.; Jacobson, Lisa P.; Brown, Todd T.
• Editors: Chaurasia., Akhilanand
• Is Part Of: Medicine. Volume 95:Issue 46(2016)
• Page Start: e5399
• Publication Date: 2016-11
• Subjects: body composition -- body mass index -- HIV -- HIV wasting syndrome -- obesity -- waist circumference -- weight-to-height ratio; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000005399
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Supplemental Digital Content is available in the text Abstract : Abstract: Examine body composition changes across the lifespan of HIV-infected compared to uninfected adults. Longitudinal study of antiretroviral therapy (ART)-treated HIV-infected and uninfected participants from the Multicenter AIDS Cohort Study and Women's Interagency HIV Study. Body mass index (BMI), waist (WC), hip circumference (HC), and waist-to-height ratio (WHtR) measured at semiannual visits from 1999 to 2014. The age effect on outcomes over time was investigated using multivariate, piecewise, linear mixed-effect regression models adjusted for demographics, substance use, and comorbidities. Person-visits from 2363 men (1059 HIV-infected/1304 HIV-uninfected) and 2200 women (1455 HIV-infected/745 HIV-uninfected), median ages 45 [IQR 39, 51] and 40 [32, 46], respectively, were included. BMI gains were slower among HIV-infected participants of 40 years or less ( P < 0.001), similar between HIV-infected and uninfected persons 40 to 60 years of age, and plateaued after age 60 in both groups. WC and WHtR increased across the age spectrum ( P < 0.001) regardless of HIV serostatus, with significantly greater gains in HIV-infected men more than 60. Black race and Hispanic ethnicity were associated with greater BMI and WC. Lower BMI, WC, hip circumference, and WHtR were associated with hepatitis C infection among women only, and with substance use among all participants, and with lower CD4 + cell count and shorter ART duration among HIV-infected participants. Slower BMI gain among younger HIV-infected adults may be partly explained by substance use and hepatitis C infection, and suggests that lower BMI does not represent improved health. Further analysis of muscle and fat abundance and quality will advance understanding of metabolic risk over the lifespan, a key to reducing morbidity in an aging population.