SEARCHCOHORTepidemiology, public health

cohort·epidemiology, public health, nutrition, infectious disease, observational study·PMC10443839

Body mass index trends and its impact of under and overweight on outcome among PLHIV on antiretroviral treatment in rural Tanzania: A prospective cohort study

PLOS ONE · 12 authors, 9 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

This prospective cohort study followed 2,129 adults living with HIV on antiretroviral therapy in rural Tanzania to track BMI changes and outcomes. It found a double burden of malnutrition at baseline, with underweight being a strong independent predictor of mortality or loss to follow-up.

Full summary

587 CHARS

The study analyzed 22,027 BMI measurements from 2,129 ART-naïve PLHIV over a median follow-up of 20 months. At baseline, 19% were underweight and 17% were overweight/obese. Piecewise linear mixed models showed BMI increased by 2% every three months during the first nine months of ART for underweight patients and by 0.7% for those with normal BMI. Cox models indicated being underweight at baseline was associated with a more than two-fold hazard of death or loss to follow-up compared to normal BMI. The findings highlight the need to address both under- and overnutrition in HIV care.

STUDY TYPE

cohort

SPECIALTY

epidemiology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10443839

Body mass index trends and its impact of under and overweight on outcome among PLHIV on antiretroviral treatment in rural Tanzania: A prospective cohort study

PLOS ONE

READ THE FULL PAPER

ABSTRACT

Abstract Introduction Increased body weight is an important risk factor for cardiovascular disease and is increasingly reported as a health problem in people living with HIV (PLHIV). There is limited data from rural sub-Saharan Africa, where malnutrition usually presents with both over- and undernutrition. We aimed to determine the prevalence and risk factors of underweight and overweight/obesity in PLHIV enrolled in a cohort in rural Tanzania before the introduction of integrase inhibitors. Methods This nested study of the prospective Kilombero and Ulanga Antiretroviral Cohort included adults aged ≥19 years initiated on antiretroviral therapy between 01/2013 and 12/2018 with follow-up through 06/2019. Body Mass Index (BMI) was classified as underweight (<18.5 kg/m 2 ), normal (18.5–24.9 kg/m 2 ), or overweight/obese (≥25.0 kg/m 2 ). Stratified piecewise linear mixed models were used to assess the association between baseline characteristics and follow-up BMI. Cox proportional hazard models were used to assess the association between time-updated BMI and death/loss to follow-up (LTFU). Results Among 2,129 patients, 22,027 BMI measurements (median 9 measurements: interquartile range 5–15) were analysed. At baseline, 398 (19%) patients were underweight and 356 (17%) were overweight/obese. The majority of patients were female (n = 1249; 59%), and aged 35–44 years (779; 37%). During the first 9 months, for every three additional months on antiretroviral therapy, BMI increased by 2% (95% confidence interval 1–2%, p<0.0001) among patients underweight at baseline and by 0.7% (0.5–0.6%, p<0.0001) among participants with normal BMI. Over a median of 20 months of follow-up, 107 (5%) patients died and 592 (28%) were LTFU. Being underweight was associated with >2 times the hazard of death/LTFU compared to participants with normal BMI. Conclusion We found a double burden of malnutrition, with underweight being an independent predictor of mortality. Monitoring and measures to address both states of malnutrition among PLHIV should be integrated into routine HIV care.

CITATION EXPORT

Aneth Vedastus Kalinjuma, Hannah Hussey, Getrud Joseph Mollel et al.. Body mass index trends and its impact of under and overweight on outcome among PLHIV on antiretroviral treatment in rural Tanzania: A prospective cohort study. PLOS ONE. (2023). https://doi.org/10.1371/journal.pone.0290445

AUTHORS

12 · 9 CENTRES

Aneth Vedastus Kalinjuma, Hannah Hussey, Getrud Joseph Mollel, Emilio Letang, Manuel Battegay, Tracy R Glass, Daniel Paris, Fiona Vanobberghen, Maja Weisser, I Marion Sumari-de Boer, I Marion Sumari-de Boer, I Marion Sumari-de Boer

1Department of Interventions and Clinical Trials, Ifakara Health Institute, Ifakara, Tanzania
2Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
3Division of Public Health, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
4St. Francis Referral Hospital, Ifakara, Tanzania
5Swiss Tropical and Public Health Institute, Allschwil, Switzerland
6Barcelona Institute for Global Health, Hospital Clínic-University of Barcelona, Barcelona, Spain
7Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
8University of Basel, Basel, Switzerland
9Kilimanjaro Clinical Research Institute, UNITED REPUBLIC OF TANZANIA