The Association Between Weight Gain, Sex, and Immune Activation Following the Initiation of Antiretroviral Therapy. (19th April 2021)

• Record Type: Journal Article
• Authors: Bares, Sara H; Smeaton, Laura M; Scott, Sarah E; Smith, Beth A; Godfrey, Catherine; McComsey, Grace A
• Is Part Of: Journal of infectious diseases. Volume 224:Number 10(2021)
• Page Start: 1765
• Page End: 1774
• Publication Date: 2021-04-19
• Subjects: HIV -- weight gain -- immune activation -- inflammation -- sex differences; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiab210
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Immune activation persists despite suppressive antiretroviral therapy (ART) and may be affected by sex or body composition. We explored these relationships in a subset of participants who initiated ART in two large randomized trials. Methods: Purposeful sampling selected participants who achieved virologic suppression on ART and either maintained weight within ± 0.5 kg/m 2 or gained 2.6–6.4 kg/m 2 from baseline to 96 weeks. We measured 7 markers of inflammation and immune activation at weeks 0 and 96. Multivariable linear regression explored associations of weight gain, sex, and pre-ART BMI with pre-ART and changes in biomarker concentrations. Results: 340 participants were selected; median pre-ART age 42 years, CD4+ cell count 273 cells/mm3, HIV-1 RNA 4.7 log10 copies/mL; 49% were women, 33% white, 42% black, and 24% Hispanic. Among participants with a normal pre-ART BMI, higher pre-ART levels of IL-6, sTNF-RI and RII, CXCL-10, sCD163 and hsCRP were associated with weight gain. Association of weight gain with week 96 changes of these biomarkers differed by sex; women who gained weight had smaller declines in most measured biomarkers compared to men who gained. Conclusions: Among women, weight gain is associated with attenuated decline in several immune activation markers following ART initiation. Clinical Trials Registration . NCT 00811954 and NCT 00811954. Abstract : Among participants with HIV initiating antiretroviral therapy in 2 randomized controlled trials, women who gained weight had smaller declines in measures of immune activation compared to men who gained weight.