title: Changes in weight and weight distribution across the lifespan among HIV-infected and -uninfected men and women.
abstract: Examine body composition changes across the lifespan of HIV-infected compared to uninfected adults. Longitudinal study of antiretroviral therapy (ART)-treated HIV-infected and uninfected participants from the Multicenter AIDS Cohort Study and Women's Interagency HIV Study. Body mass index (BMI), waist (WC), hip circumference (HC), and waist-to-height ratio (WHtR) measured at semiannual visits from 1999 to 2014. The age effect on outcomes over time was investigated using multivariate, piecewise, linear mixed-effect regression models adjusted for demographics, substance use, and comorbidities. Person-visits from 2363 men (1059 HIV-infected/1304 HIV-uninfected) and 2200 women (1455 HIV-infected/745 HIV-uninfected), median ages 45 [IQR 39,51] and 40 [32,46], respectively, were included. BMI gains were slower among HIV-infected participants of 40 years or less (P < 0.001), similar between HIV-infected and uninfected persons 40 to 60 years of age, and plateaued after age 60 in both groups. WC and WHtR increased across the age spectrum (P < 0.001) regardless of HIV serostatus, with significantly greater gains in HIV-infected men more than 60. Black race and Hispanic ethnicity were associated with greater BMI and WC. Lower BMI, WC, hip circumference, and WHtR were associated with hepatitis C infection among women only, and with substance use among all participants, and with lower CD4 cell count and shorter ART duration among HIV-infected participants. Slower BMI gain among younger HIV-infected adults may be partly explained by substance use and hepatitis C infection, and suggests that lower BMI does not represent improved health. Further analysis of muscle and fat abundance and quality will advance understanding of metabolic risk over the lifespan, a key to reducing morbidity in an aging population.
authors.affiliation: University of Colorado, Aurora, CO Johns Hopkins Bloomberg School of Public Health, Baltimore, MD University of California, Los Angeles, CA Albert Einstein College of Medicine, Bronx, NY University of California San Francisco, CA and the Department of Veterans Affairs, San Francisco, CA Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Erlandson
authors.forename: Long
authors.initials: L
authors.lastname: Zhang
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Lake
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schrack
authors.forename: Keri
authors.initials: K
authors.lastname: Althoff
authors.forename: Anjali
authors.initials: A
authors.lastname: Sharma
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Margolick
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Jacobson
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
mesh_terms: D000328:Adult; D000367:Age Factors; D000886:Anthropometry / Q000379:methods; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D018791:CD4 Lymphocyte Count / Q000379:methods; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents