title: Changes in Body Mass Index Following HAART Initiation among HIV-Infected Women in the Women's Interagency HIV Study.
abstract: OBJECTIVE
  Examine changes in, and factors associated with changing body mass index (BMI) in women following highly active antiretroviral therapy (HAART) initiation.
  
  
  METHODS
  1177 HIV-infected Women's Interagency HIV Study participants who contributed 10,754 years of follow-up following HAART initiation were studied. Changes in median BMI up to 15 years following HAART initiation, and the highest and lowest BMI reached following HAART initiation were summarized by pre-HAART BMI category (<18.5 [underweight], 18.5-<25.0 [normal weight], 25.0-<30.0 [overweight], 30.0-<40.0 [obese], and ≥ 40.0 [morbidly obese]). Multivariate mixed effects ordinal logistic regression estimated the degree of association of each exposure of interest with post-HAART BMI.
  
  
  RESULTS
  Before HAART, 39% percent of women had normal BMI, 31% were overweight, 23% were obese, and 5% were morbidly obese. Following HAART initiation, median BMI change (per 5 years) was 0.21 kg/m2(90% confidence interval [CI]: -1.33, 0.42) for those with normal pre-HAART BMI, 0.39 kg/m2(90% CI: 0.15,0.66) for overweight, 0.31 kg/m2(90% CI: -1.18,0.67) for obese, and -0.36kg/m2for morbidly obese women. After initiating HAART, 40% with normal pre-HAART BMI became overweight at some point; of those overweight, 46% remained overweight and 47% became obese; 71% of obese women remained obese and 27% became morbidly obese. Each year of nucleoside analog reverse transcriptase inhibitor use was associated with a 3% decreased odds of reaching a higher BMI category (OR 0.97, 95% CI: 0.95, 0.99), while each year of protease inhibitor or non-nucleoside analog reverse transcriptase inhibitor use were associated with a 6% (OR 1.06, 95% CI: 1.04, 1.08) and 5%(OR 1.05, 95% CI: 1.01, 1.08) increased odds of having a higher BMI category, respectively.
  
  
  CONCLUSIONS
  Although overweight and obesity are highly prevalent in this large cohort of HIV-infected, minority women, HAART use was associated with only a modest increase in BMI over time.
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Anjali
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Social and Behavioral Sciences, Uniformed Services University of the Health Sciences, Bethesda, USA.
authors.forename: Shalanda A
authors.initials: SA
authors.lastname: Bynum
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Schneider
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Cox
authors.affiliation: Department of Medicine, University of California at San Francisco, USA.
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
authors.affiliation: Department of Epidemiology, University of Illinois at Chicago, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Hershow
authors.affiliation: Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Gustafson
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Plankey
keywords: Body mass index; HAART; HIV; Obesity; Women; Women's interagency HIV study