title: High prevalence of being Overweight and Obese HIV-infected persons, before and after 24 months on early ART in the ANRS 12136 Temprano Trial.
abstract: BACKGROUND
  HIV is usually associated with weight loss. World health Organization (WHO) recommends early antiretroviral (ART) initiation, but data on the progression of body mass index (BMI) in participants initiating early ART in Africa are scarce.
  
  
  METHODS
  The Temprano randomized trial was conducted in Abidjan to assess the effectiveness of early ART and Isoniazid (INH) prophylaxis for tuberculosis in HIV-infected persons with high CD4 counts below 800 cells/mm(3) without any indication for starting ART. Patients initiating early ART before December 2010 were included in this sub-study. BMI was categorized as: underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)) and obese (≥30 kg/m(2)). At baseline and after 24 months of ART, prevalence of being overweight or obese and factors associated with being overweight or obese were estimated using univariate and multivariate logistic regression.
  
  
  RESULTS
  At baseline, 755 participants (78 % women; median CD4 count 442/mm(3), median baseline BMI 22 kg/m(2)) initiated ART. Among them, 19.7 % were overweight, and 7.2 % were obese at baseline. Factors associated with being overweight or obese were: female sex aOR 2.3 (95 % CI 1.4-3.7), age, aOR for 5 years 1.01 (95 % CI 1.0-1.2), high living conditions aOR 2.6 (95 % CI 1.5-4.4), High blood pressure aOR 4.3 (95 % CI 2.0-9.2), WHO stage 2vs1 aOR 0.7 (95 % CI 0.4-1.0) and Hemoglobin ≥95 g/dl aOR 3.0 (95 % CI 1.6-5.8). Among the 597 patients who attended the M24 visit, being overweight or obese increased from 20.4 to 24.8 % (p = 0.01) and 7.2 to 9.2 % (p = 0.03) respectively and factor associated with being overweight or obese was immunological response measured as an increase of CD4 cell count between M0-M24 (for +50 cells/mm(3): aOR 1.01; 95 % CI 1.05-1.13, p = 0.01).
  
  
  CONCLUSIONS
  The weight categories overweight and obese are highly prevalent in HIV-infected persons with high CD4 cell counts at baseline, and increased over 24 months on ART in this Sub-Saharan African population.
authors.affiliation: Unité de Soins Ambulatoire et de Conseil (USAC), 18 BP, 1125 Abidjan 18, Côte d'Ivoire.
authors.forename: Calixte
authors.initials: C
authors.lastname: Guehi
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire ; Inserm U 1219, Bordeaux University, Bordeaux, France.
authors.forename: Anani
authors.initials: A
authors.lastname: Badjé
authors.affiliation: Inserm U 1219, Bordeaux University, Bordeaux, France ; ISPED, Bordeaux University, Bordeaux, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Gabillard
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire ; Inserm U 1219, Bordeaux University, Bordeaux, France ; ISPED, Bordeaux University, Bordeaux, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Ouattara
authors.affiliation: Unité de Soins Ambulatoire et de Conseil (USAC), 18 BP, 1125 Abidjan 18, Côte d'Ivoire.
authors.forename: Serge Olivier
authors.initials: SO
authors.lastname: Koulé
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire ; Department of Infectious Diseases, Treichville Hospital, Abidjan, Côte d'Ivoire.
authors.forename: Raoul
authors.initials: R
authors.lastname: Moh
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire ; Inserm U 1219, Bordeaux University, Bordeaux, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Ekouevi
authors.affiliation: Centre de Recherche et Diagnostic sur le SIDA, (Cedres) CHU de Treichville, Abidjan, Côte d'Ivoire.
authors.forename: Hugues
authors.initials: H
authors.lastname: Ahibo
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire.
authors.forename: Jean Baptiste
authors.initials: JB
authors.lastname: N'Takpé
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire.
authors.forename: Gérard Kouamé
authors.initials: GK
authors.lastname: Menan
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire.
authors.forename: Nina
authors.initials: N
authors.lastname: Deschamps
authors.affiliation: Inserm U 1219, Bordeaux University, Bordeaux, France ; ISPED, Bordeaux University, Bordeaux, France.
authors.forename: Jerôme
authors.initials: J
authors.lastname: Lecarrou
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire ; Department of Infectious Diseases, Treichville Hospital, Abidjan, Côte d'Ivoire.
authors.forename: Serge
authors.initials: S
authors.lastname: Eholié
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire ; Inserm U 1219, Bordeaux University, Bordeaux, France ; ISPED, Bordeaux University, Bordeaux, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Anglaret
authors.affiliation: Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire ; Inserm U 1219, Bordeaux University, Bordeaux, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Danel
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use; D015992:Body Mass Index; D007560:Cote d'Ivoire / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D050177:Overweight / Q000150:complications* / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control; D015431:Weight Loss / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents; D007538:Isoniazid
keywords: Africa; Early ART; HIV infection; Obesity