SidaSubSaharaV1, Main, Merge, bibRecord, 000F93

Higher Time-updated Body Mass Index: Association with Improved CD4+ Cell Recovery on HIV Treatment

Identifieur interne : 000F93 ( Main/Merge ); précédent : 000F92; suivant : 000F94

Higher Time-updated Body Mass Index: Association with Improved CD4+ Cell Recovery on HIV Treatment

Auteurs : John R. Koethe [États-Unis] ; Cathy A. Jenkins [États-Unis] ; Bryan Lau [États-Unis] ; Bryan E. Shepherd [États-Unis] ; William Wester [États-Unis] ; Peter F. Rebeiro [États-Unis] ; Michael J. Silverberg ; Jennifer E. Thorne [États-Unis] ; John Gill [Canada] ; Angel M. Mayor [Porto Rico] ; Amanda Willig [États-Unis] ; Ronald Bosch [États-Unis] ; Michael A. Horberg [États-Unis] ; Amy C. Justice ; Timothy R. Sterling [États-Unis] ; Richard D. Moore [États-Unis]

Source :

Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2016.

RBID : PMC:5023455

Abstract

Background

Prior studies found overweight or obese HIV-infected individuals had greater early CD4+ cell recovery on antiretroviral therapy (ART), but the results have been inconsistent. We assessed the longitudinal relationship between body mass index (BMI) and CD4+ cell recovery on ART in a large, multi-site cohort to identify potential physiologic links between adiposity and CD4+ cell expansion.

Methods

We modeled the relationship of time-updated BMI with CD4+ count in patients starting ART from 17 North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) cohorts. The primary analysis used a linear mixed effects model incorporating up to 13 years of data per patient and adjusted for age, sex, race, ART regimen, baseline CD4+ count and other covariates. Sensitivity analyses limited the cohort to patients with sustained viral suppression or censored at virologic failure.

Results

14,084 HIV-infected individuals initiating ART contributed data between 1998 and 2010. Time-updated BMI was significantly associated with CD4+ cell recovery over time (p<0.001). After 5 years of ART, the mean CD4+ count at a BMI of 30 kg/m² was 22% higher than at a BMI of 22 kg/m² (606 vs. 498 cells/µL), and 34% higher at a BMI of 40 kg/m² (665 vs. 498 cells/µL). Results were similar in the sensitivity analyses.

Discussion

Higher BMI is associated with long-term advantages in immune recovery on ART. While it is unclear if this impacts health outcomes, including balancing the negative health effects of obesity, elucidating the underlying mechanism could identify therapies for patients with suboptimal immune reconstitution.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023455

DOI: 10.1097/QAI.0000000000001035
PubMed: 27116044
PubMed Central: 5023455

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PMC:5023455

Le document en format XML

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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
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<author><name sortKey="Gill, John" sort="Gill, John" uniqKey="Gill J" first="John" last="Gill">John Gill</name>
<affiliation wicri:level="1"><nlm:aff id="A4">Alberta HIV Clinic, Sheldon M Chumir Health Centre, Calgary, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Alberta HIV Clinic, Sheldon M Chumir Health Centre, Calgary</wicri:regionArea>
<wicri:noRegion>Calgary</wicri:noRegion>
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<author><name sortKey="Mayor, Angel M" sort="Mayor, Angel M" uniqKey="Mayor A" first="Angel M." last="Mayor">Angel M. Mayor</name>
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<wicri:noRegion>Bayamon</wicri:noRegion>
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<author><name sortKey="Willig, Amanda" sort="Willig, Amanda" uniqKey="Willig A" first="Amanda" last="Willig">Amanda Willig</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
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<author><name sortKey="Bosch, Ronald" sort="Bosch, Ronald" uniqKey="Bosch R" first="Ronald" last="Bosch">Ronald Bosch</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
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</affiliation>
</author>
<author><name sortKey="Horberg, Michael A" sort="Horberg, Michael A" uniqKey="Horberg M" first="Michael A." last="Horberg">Michael A. Horberg</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
<wicri:cityArea>Kaiser Permanente, Mid-Atlantic Permanente Research Institute, Rockville</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Justice, Amy C" sort="Justice, Amy C" uniqKey="Justice A" first="Amy C." last="Justice">Amy C. Justice</name>
<affiliation><nlm:aff id="A9">Yale University School of Medicine, New Haven and Veterans Affairs (VA) Connecticut Healthcare System, West Haven</nlm:aff>
<wicri:noCountry code="subfield">West Haven</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Sterling, Timothy R" sort="Sterling, Timothy R" uniqKey="Sterling T" first="Timothy R." last="Sterling">Timothy R. Sterling</name>
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<country xml:lang="fr">États-Unis</country>
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</author>
<author><name sortKey="Moore, Richard D" sort="Moore, Richard D" uniqKey="Moore R" first="Richard D." last="Moore">Richard D. Moore</name>
<affiliation wicri:level="2"><nlm:aff id="A2">Johns Hopkins University, Baltimore, Maryland</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
</placeName>
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<series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title>
<idno type="ISSN">1525-4135</idno>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Prior studies found overweight or obese HIV-infected individuals had greater early CD4+ cell recovery on antiretroviral therapy (ART), but the results have been inconsistent. We assessed the longitudinal relationship between body mass index (BMI) and CD4+ cell recovery on ART in a large, multi-site cohort to identify potential physiologic links between adiposity and CD4+ cell expansion.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We modeled the relationship of time-updated BMI with CD4+ count in patients starting ART from 17 North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) cohorts. The primary analysis used a linear mixed effects model incorporating up to 13 years of data per patient and adjusted for age, sex, race, ART regimen, baseline CD4+ count and other covariates. Sensitivity analyses limited the cohort to patients with sustained viral suppression or censored at virologic failure.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">14,084 HIV-infected individuals initiating ART contributed data between 1998 and 2010. Time-updated BMI was significantly associated with CD4+ cell recovery over time (p<0.001). After 5 years of ART, the mean CD4+ count at a BMI of 30 kg/m<sup>2</sup>
 was 22% higher than at a BMI of 22 kg/m<sup>2</sup>
 (606 vs. 498 cells/µL), and 34% higher at a BMI of 40 kg/m<sup>2</sup>
 (665 vs. 498 cells/µL). Results were similar in the sensitivity analyses.</p>
</sec>
<sec id="S4"><title>Discussion</title>
<p id="P4">Higher BMI is associated with long-term advantages in immune recovery on ART. While it is unclear if this impacts health outcomes, including balancing the negative health effects of obesity, elucidating the underlying mechanism could identify therapies for patients with suboptimal immune reconstitution.</p>
</sec>
</div>
</front>
</TEI>
</record>

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Higher Time-updated Body Mass Index: Association with Improved CD4+ Cell Recovery on HIV Treatment

Higher Time-updated Body Mass Index: Association with Improved CD4+ Cell Recovery on HIV Treatment

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Abstract

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