title: Predictors of weight loss after HAART initiation among HIV-infected adults in Tanzania.
abstract: OBJECTIVE
  To explore the predictors of weight loss after highly active antiretroviral therapy (HAART) initiation in a large cohort of HIV-infected adults living in Dar es Salaam, Tanzania.
  
  
  METHODS
  Cross-sectional and longitudinal analysis of a cohort of HIV-infected adults on HAART.
  
  
  METHODS
  HIV-infected adults (n = 18 965) were enrolled between November 2004 to December 2009 in Dar es Salaam, Tanzania. Log-binomial regression and Cox proportional hazard regression were used to explore the predictors of short-term (3 months) and long-term significant weight loss (≥ 5%) after HAART initiation.
  
  
  RESULTS
  At 3 months after HAART initiation, 8% patients lost greater than or equal to 5% weight. Underweight patients at initiation gained more weight than other body mass index (BMI) groups. Younger or older than age group 30-39, lower socioeconomic status (SES), higher BMI, lower hemoglobin, difficulty breathing, loss of appetite, nausea/vomiting at baseline were associated with the risk of significant weight loss at 3 months after initiation. During a median follow-up period of 10 months [interquartile range (IQR) 4-20 months], 31% patients had experienced an initial significant weight loss after HAART initiation. In addition to time-varying CD4 cell count and hemoglobin level, age, sex, baseline BMI and having loss of appetite, and nausea/vomiting at baseline were associated with the risk of long-term significant weight loss.
  
  
  CONCLUSIONS
  Our study suggested that a significant percentage of patients continue to lose weight after HAART initiation. Our findings on the effect of socio-demographics, symptoms and diseases, biomedical indicators in relation to weight loss provide important information that has significant practical implications.
authors.affiliation: Department of NutritionSchool of Public Health, Harvard University, Boston, Massachusetts 02120, USA. nli@hsph.harvard.edu
authors.forename: Nan
authors.initials: N
authors.lastname: Li
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Paul
authors.initials: P
authors.lastname: Drain
authors.forename: Ramadhani S
authors.initials: RS
authors.lastname: Mwiru
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Mugusi
authors.forename: Guerino
authors.initials: G
authors.lastname: Chalamilla
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001835:Body Weight / Q000187:drug effects; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013636:Tanzania; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects* / Q000502:physiology; D055815:Young Adult