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Body mass index and early CD4 T-cell recovery among adults initiating antiretroviral therapy in North America, 1998-2010.
- Source :
- HIV Medicine; Oct2015, Vol. 16 Issue 9, p572-577, 6p
- Publication Year :
- 2015
-
Abstract
- Objectives Adipose tissue affects several aspects of the cellular immune system, but prior epidemiological studies have differed on whether a higher body mass index ( BMI) promotes CD4 T-cell recovery on antiretroviral therapy ( ART). The objective of this analysis was to assess the relationship between BMI at ART initiation and early changes in CD4 T-cell count. Methods We used the North American AIDS Cohort Collaboration on Research and Design ( NA- ACCORD) data set to analyse the relationship between pre-treatment BMI and 12-month CD4 T-cell recovery among adults who started ART between 1998 and 2010 and maintained HIV-1 RNA levels < 400 copies/mL for at least 6 months. Multivariable regression models were adjusted for age, race, sex, baseline CD4 count and HIV RNA level, year of ART initiation, ART regimen and clinical site. Results A total of 8381 participants from 13 cohorts contributed data; 85% were male, 52% were nonwhite, 32% were overweight ( BMI 25-29.9 kg/m<superscript>2</superscript>) and 15% were obese ( BMI > 30 kg/m<superscript>2</superscript>). Pretreatment BMI was associated with 12-month CD4 T-cell change ( P < 0.001), but the relationship was nonlinear ( P < 0.001). Compared with a reference of 22 kg/m<superscript>2</superscript>, a BMI of 30 kg/m<superscript>2</superscript> was associated with a 36 cells/μL [95% confidence interval ( CI) 14, 59 cells/μL] greater CD4 T-cell count recovery among women and a 19 cells/μL (95% CI 9, 30 cells/μL) greater recovery among men at 12 months. At a BMI > 30 kg/m<superscript>2</superscript>, the observed benefit was attenuated among men to a greater degree than among women, although this difference was not statistically significant. Conclusions A BMI of approximately 30 kg/m<superscript>2</superscript> at ART initiation was associated with greater CD4 T-cell recovery at 12 months compared with higher or lower BMI values, suggesting that body composition may affect peripheral CD4 T-cell recovery. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14642662
- Volume :
- 16
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- HIV Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 109227802
- Full Text :
- https://doi.org/10.1111/hiv.12259