Inflammation and Change in Body Weight With Antiretroviral Therapy Initiation in a Multinational Cohort of HIV-Infected Adults. (8th March 2016)

• Record Type: Journal Article
• Authors: Mave, Vidya; Erlandson, Kristine M.; Gupte, Nikhil; Balagopal, Ashwin; Asmuth, David M.; Campbell, Thomas B.; Smeaton, Laura; Kumarasamy, Nagalingeswaran; Hakim, James; Santos, Breno; Riviere, Cynthia; Hosseinipour, Mina C.; Sugandhavesa, Patcharaphan; Infante, Rosa; Pillay, Sandy; Cardoso, Sandra W.; Tripathy, Srikanth; Mwelase, Noluthando; Berendes, Sima; Andrade, Bruno B.; Thomas, David L.; Bollinger, Robert C.; Gupta, Amita
• Is Part Of: Journal of infectious diseases. Volume 214:Number 1(2016:Jul. 01)
• Page Start: 65
• Page End: 72
• Publication Date: 2016-03-08
• Subjects: immune activation/inflammation -- body mass index -- HIV/AIDS -- HAART clinical outcomes -- noncommunicable diseases; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiw096
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract : 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.