title: Inflammation and Change in Body Weight With Antiretroviral Therapy Initiation in a Multinational Cohort of HIV-Infected Adults.
abstract: BACKGROUND
  Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation during human immunodeficiency virus infection is unknown.
  
  
  METHODS
  Among a random virologically suppressed participants of the Prospective Evaluation of Antiretrovirals in Resource-Limited Settings trial, inflammatory markers were measured at weeks 0, 24, and 48 after antiretroviral therapy (ART) initiation. Associations between both baseline and change in body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) and changes in inflammation markers were assessed using random effects models.
  
  
  RESULTS
  Of 246 participants, 27% were overweight/obese (BMI, ≥ 25), and 8% were underweight (BMI < 18.5) at baseline. After 48 weeks, 37% were overweight/obese, and 3% were underweight. While level of many inflammatory markers decreased 48 weeks after ART initiation in the overall group, the decrease in C-reactive protein (CRP) level was smaller in overweight/obese participants (P = .01), and the decreases in both CRP (P = .01) and interleukin 18 (P = .02) levels were smaller in underweight participants. Each 1-unit gain in BMI among overweight/obese participants was associated with a 0.02-log10 increase in soluble CD14 level (P = .05), while each 1-unit BMI gain among underweight participants was associated with a 9.32-mg/L decrease in CRP level (P = .001).
  
  
  CONCLUSIONS
  Being either overweight or underweight at ART initiation was associated with heightened systemic inflammation. While weight gain among overweight/obese persons predicted increased inflammation, weight gain among underweight persons predicted reduced inflammation.
authors.affiliation: Johns Hopkins University-BJ Medical College Clinical Research Site, Pune, India Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Vidya
authors.initials: V
authors.lastname: Mave
authors.affiliation: Department of Medicine, University of Colorado Denver, Aurora.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Erlandson
authors.affiliation: Johns Hopkins University-BJ Medical College Clinical Research Site, Pune, India Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Gupte
authors.affiliation: Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Balagopal
authors.affiliation: Department of Medicine, University California Davis, Sacramento.
authors.forename: David M
authors.initials: DM
authors.lastname: Asmuth
authors.affiliation: Department of Medicine, University of Colorado Denver, Aurora.
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Campbell
authors.affiliation: Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Laura
authors.initials: L
authors.lastname: Smeaton
authors.affiliation: Y. R. Gaitonde Center for AIDS Research and Education, Chennai, India.
authors.forename: Nagalingeswaran
authors.initials: N
authors.lastname: Kumarasamy
authors.affiliation: University of Zimbabwe, Harare.
authors.forename: James
authors.initials: J
authors.lastname: Hakim
authors.affiliation: Hospital Nossa Senhora de Conceição, Porto Alegre, Brazil.
authors.forename: Breno
authors.initials: B
authors.lastname: Santos
authors.affiliation: Les Centres GHESKIO, Port-Au-Prince, Haiti.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Riviere
authors.affiliation: University of North Carolina Project, Lilongwe, Malawi.
authors.forename: Mina C
authors.initials: MC
authors.lastname: Hosseinipour
authors.affiliation: Research Institute for Health Sciences, Chiang Mai, Thailand.
authors.forename: Patcharaphan
authors.initials: P
authors.lastname: Sugandhavesa
authors.affiliation: IMPACTA Peru, San Miguel.
authors.forename: Rosa
authors.initials: R
authors.lastname: Infante
authors.affiliation: Durban International Clinical Research Site, Durban University of Technology, South Africa.
authors.forename: Sandy
authors.initials: S
authors.lastname: Pillay
authors.affiliation: STD/AIDS Clinical Research Laboratory, Instituto de Pesquisa Clinica Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Cardoso
authors.affiliation: National AIDS Research Institute, Pune, India.
authors.forename: Srikanth
authors.initials: S
authors.lastname: Tripathy
authors.affiliation: Department of Medicine, University of Witwatersrand, Johannesburg, South Africa.
authors.forename: Noluthando
authors.initials: N
authors.lastname: Mwelase
authors.affiliation: Malawi College of Medicine-Johns Hopkins University Research Project, Blantyre Liverpool School of Tropical Medicine, United Kingdom.
authors.forename: Sima
authors.initials: S
authors.lastname: Berendes
authors.affiliation: Unidade de Medicina Investigativa, Laboratório Integrado de Microbiologia e Imunorregulação, Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, and Instituto Brasileiro para a Investigação da Tuberculose, Fundação José Silveira, Salvador, Brazil.
authors.forename: Bruno B
authors.initials: BB
authors.lastname: Andrade
authors.affiliation: Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland.
authors.forename: David L
authors.initials: DL
authors.lastname: Thomas
authors.affiliation: Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bollinger
authors.affiliation: Johns Hopkins University-BJ Medical College Clinical Research Site, Pune, India Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Amita
authors.initials: A
authors.lastname: Gupta
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects*; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006205:Haiti; D006801:Humans; D007194:India; D007249:Inflammation / Q000139:chemically induced*; D008295:Malawi; D008297:Male; D010568:Peru; D011446:Prospective Studies; D013019:South Africa; D013785:Thailand; D014481:United States; D015430:Weight Gain / Q000187:drug effects*; D015431:Weight Loss / Q000187:drug effects*; D015030:Zimbabwe
chemical_list: D019380:Anti-HIV Agents
keywords: HAART clinical outcomes; HIV/AIDS; body mass index; immune activation/inflammation; noncommunicable diseases