Weight loss and body mass index as predictors of HIV disease progression to AIDS in adults. Aquitaine cohort, France, 1985-1997.
OBJECTIVE
To assess the performance of weight related nutritional markers (reported involuntary weight loss greater than 10%, measured weight loss and body mass index-BMI-) in predicting HIV disease progression.


METHODS
Multirisk cohort of HIV-1 infected patients.


METHODS
The three nutritional variables were studied in Cox proportional hazard models as time dependant variables.


RESULTS
The sample included 2376 subjects (median follow up: 43.1 months), of those 675 experienced an AIDS defining event. After adjustment for well known prognostic factors, the reported weight loss greater than 10% tripled the risk of progression to clinical AIDS (Hazard ratio [HR] 3.0. 95% confidence interval [CI] 2.5-3.7). For measured weight loss under 5%. between 5% and 10% and greater than 10% of baseline weight compared with no weight loss, hazard ratios were respectively 1.8 (CI 1.5-2.2), 2.6 (CI 2.1-3.2) and 5.1 (CI 4.1-6.4). The relative risks of AIDS were 1.7 (CI 1.3-2.2) for BMI between 17 kg/m2 and 18.5 kg/m2, 2.6 (CI 1.7-4.0) for BMI between 16 kg/m2 and 17 kg/m2 and 4.7 (CI 3.0-7.4) for BMI under 16 kg/m2.


CONCLUSIONS
Even a limited weight loss measured at a given time during follow up increases the risk of HIV progression; moreover, a simple cross-sectionnal measure of BMI has a good predictive value for subsequent development of clinical disease.
Malvy
E
E
Unité INSERM 330, Université Victor Segalen Bordeaux 2, Hĵpital Saint-André, Centre Hospitalier Universitaire de Bordeaux, France. crdess@crl.u-boedeaux2.fr
Thiébaut
R
R
Marimoutou
C
C
Dabis
F
F
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005602:France; D006678:HIV / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D015431:Weight Loss / Q000502:physiology*