Body mass index and early CD4 T-cell recovery among adults initiating antiretroviral therapy in North America, 1998-2010
- PMID: 25960080
- PMCID: PMC4558259
- DOI: 10.1111/hiv.12259
Body mass index and early CD4 T-cell recovery among adults initiating antiretroviral therapy in North America, 1998-2010
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(2) ) and 15% were obese (BMI > 30 kg/m(2) ). 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(2) , a BMI of 30 kg/m(2) 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(2) , 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(2) 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.
Keywords: HIV; antiretroviral therapy; immune reconsitition; nutrition; obesity.
© 2015 British HIV Association.
Figures
Similar articles
-
Predictive effects of body mass index on immune reconstitution among HIV-infected HAART users in China.BMC Infect Dis. 2019 May 2;19(1):373. doi: 10.1186/s12879-019-3991-6. BMC Infect Dis. 2019. PMID: 31046702 Free PMC article.
-
HIV-Infected Women Gain More Weight than HIV-Infected Men Following the Initiation of Antiretroviral Therapy.J Womens Health (Larchmt). 2018 Sep;27(9):1162-1169. doi: 10.1089/jwh.2017.6717. Epub 2018 Apr 2. J Womens Health (Larchmt). 2018. PMID: 29608129 Free PMC article.
-
Higher Time-Updated Body Mass Index: Association With Improved CD4+ Cell Recovery on HIV Treatment.J Acquir Immune Defic Syndr. 2016 Oct 1;73(2):197-204. doi: 10.1097/QAI.0000000000001035. J Acquir Immune Defic Syndr. 2016. PMID: 27116044 Free PMC article.
-
Rising Obesity Prevalence and Weight Gain Among Adults Starting Antiretroviral Therapy in the United States and Canada.AIDS Res Hum Retroviruses. 2016 Jan;32(1):50-8. doi: 10.1089/aid.2015.0147. Epub 2015 Sep 9. AIDS Res Hum Retroviruses. 2016. PMID: 26352511 Free PMC article.
-
An optimal body mass index range associated with improved immune reconstitution among HIV-infected adults initiating antiretroviral therapy.Clin Infect Dis. 2011 Nov;53(9):952-60. doi: 10.1093/cid/cir606. Epub 2011 Sep 26. Clin Infect Dis. 2011. PMID: 21946189 Free PMC article.
Cited by
-
Changes in Body Mass Index Over Time in People With and Without HIV Infection.Open Forum Infect Dis. 2024 Feb 6;11(2):ofad611. doi: 10.1093/ofid/ofad611. eCollection 2024 Feb. Open Forum Infect Dis. 2024. PMID: 38323078 Free PMC article.
-
High baseline body mass index predicts recovery of CD4+ T lymphocytes for HIV/AIDS patients receiving long-term antiviral therapy.PLoS One. 2022 Dec 30;17(12):e0279731. doi: 10.1371/journal.pone.0279731. eCollection 2022. PLoS One. 2022. PMID: 36584083 Free PMC article.
-
Analysis of the Influencing Factors of Immunological Nonresponders in Wuhan, China.Can J Infect Dis Med Microbiol. 2022 Aug 8;2022:5638396. doi: 10.1155/2022/5638396. eCollection 2022. Can J Infect Dis Med Microbiol. 2022. PMID: 35979516 Free PMC article.
-
HIV viral load non-suppression and associated factors among pregnant and postpartum women in rural northeastern South Africa: a cross-sectional survey.BMJ Open. 2022 Mar 10;12(3):e058347. doi: 10.1136/bmjopen-2021-058347. BMJ Open. 2022. PMID: 35273061 Free PMC article.
-
Factors associated with prognostic or treatment outcomes in HIV/AIDS patients with and without hypertension in Eswatini.Sci Rep. 2021 Jun 21;11(1):12955. doi: 10.1038/s41598-021-92185-0. Sci Rep. 2021. PMID: 34155234 Free PMC article.
References
-
- Lewden C, Chene G, Morlat P, et al. HIV-infected adults with a CD4 cell count greater than 500 cells/mm3 on long-term combination antiretroviral therapy reach same mortality rates as the general population. J Acquir Immune Defic Syndr. 2007;46:72–77. - PubMed
-
- Moore RD, Keruly JC. CD4+ cell count 6 years after commencement of highly active antiretroviral therapy in persons with sustained virologic suppression. Clin Infect Dis. 2007;44:441–446. - PubMed
-
- Torti C, Prosperi M, Motta D, et al. Factors influencing the normalization of CD4+ T-cell count, percentage and CD4+/CD8+ T-cell ratio in HIV-infected patients on long-term suppressive antiretroviral therapy. Clin Microbiol Infect. 18:449–458. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
- R01 AA016893/AA/NIAAA NIH HHS/United States
- P30 AI027767/AI/NIAID NIH HHS/United States
- U01 AI035042/AI/NIAID NIH HHS/United States
- P30 MH062246/MH/NIMH NIH HHS/United States
- U01 AI069434/AI/NIAID NIH HHS/United States
- U01 AI037984/AI/NIAID NIH HHS/United States
- R01 DA011602/DA/NIDA NIH HHS/United States
- U01 AI031834/AI/NIAID NIH HHS/United States
- P30 AI094189/AI/NIAID NIH HHS/United States
- U01 AI035004/AI/NIAID NIH HHS/United States
- G12 MD007583/MD/NIMHD NIH HHS/United States
- P30 AI054999/AI/NIAID NIH HHS/United States
- K24 DA000432/DA/NIDA NIH HHS/United States
- K23 MH096647/MH/NIMH NIH HHS/United States
- U01 DA036935/DA/NIDA NIH HHS/United States
- U01 AI038855/AI/NIAID NIH HHS/United States
- U54 MD007587/MD/NIMHD NIH HHS/United States
- R01 DA004334/DA/NIDA NIH HHS/United States
- K23 AI100700/AI/NIAID NIH HHS/United States
- UL1 RR024131/RR/NCRR NIH HHS/United States
- U01 AI034989/AI/NIAID NIH HHS/United States
- U01 AI037613/AI/NIAID NIH HHS/United States
- UM1 AI068634/AI/NIAID NIH HHS/United States
- U01 AI035041/AI/NIAID NIH HHS/United States
- R24 AI067039/AI/NIAID NIH HHS/United States
- U01-AI069918/AI/NIAID NIH HHS/United States
- UM1 AI035043/AI/NIAID NIH HHS/United States
- U01 AI069432/AI/NIAID NIH HHS/United States
- N02CP55504/CP/NCI NIH HHS/United States
- U01 AI038858/AI/NIAID NIH HHS/United States
- U01 AI068636/AI/NIAID NIH HHS/United States
- U01 AI034994/AI/NIAID NIH HHS/United States
- M01 RR000052/RR/NCRR NIH HHS/United States
- P30 AI027763/AI/NIAID NIH HHS/United States
- U01 AI069918/AI/NIAID NIH HHS/United States
- K24 AI065298/AI/NIAID NIH HHS/United States
- KL2 TR002317/TR/NCATS NIH HHS/United States
- U01 AI035043/AI/NIAID NIH HHS/United States
- UL1 TR000083/TR/NCATS NIH HHS/United States
- P30 AI027757/AI/NIAID NIH HHS/United States
- R01 DA012568/DA/NIDA NIH HHS/United States
- UL1 RR024975/RR/NCRR NIH HHS/United States
- KL2 TR000421/TR/NCATS NIH HHS/United States
- U01 AI035040/AI/NIAID NIH HHS/United States
- R56 AI102622/AI/NIAID NIH HHS/United States
- U01 AI034993/AI/NIAID NIH HHS/United States
- U01 AI035039/AI/NIAID NIH HHS/United States
- P30 AI036219/AI/NIAID NIH HHS/United States
- U01 AI068634/AI/NIAID NIH HHS/United States
- P30 AI050410/AI/NIAID NIH HHS/United States
- U01 HD032632/HD/NICHD NIH HHS/United States
- U01 AI042590/AI/NIAID NIH HHS/United States
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials