Crum-Cianflone Nancy, Tejidor Raechel, Medina Sheila, Barahona Irma, Ganesan Anuradha
HIV Clinic, Naval Medical Center San Diego, San Diego, California 92134, USA.
AIDS Patient Care STDS. 2008 Dec;22(12):925-30. doi: 10.1089/apc.2008.0082.
Since the advent of highly active antiretroviral therapy (HAART), studies have been conflicting regarding weight information among patients with HIV. We performed a retrospective study among male patients with HIV between June 2004 and June 2005 at two large U.S. Navy HIV clinics to describe the prevalence and factors associated with being overweight/obese. Rates of obesity/overweight among HIV-positive patients were also compared to data from HIV-negative military personnel. Of the 661 HIV-infected patients, 419 (63%) were overweight/obese and only 5 (1%) were underweight. Patients with HIV had a mean age of 41.0 years (range, 20-73 years) and were racially diverse. The prevalence rates of being overweight/obese at the last visit were similar among both HIV-positive and -negative military members. Being overweight/obese at the last clinic visit was associated with gaining weight during the course of HIV infection (10.4 versus 4.0 pounds, p < 0.001), hypertension (36% versus 23%, p = 0.001), low high-density lipoprotein (HDL; 40% versus 31%, p < 0.001), and a higher CD4 cell count at last visit (592 versus 499 cells/mm(3), p < 0.001). These data demonstrate that patients with HIV in the HAART era are commonly overweight and/or obese with rates similar to the general population. Being overweight/obese is associated with hypertension and dyslipidemia. Weight assessment and management programs should be a part of routine HIV clinical care.
自从高效抗逆转录病毒疗法(HAART)问世以来,关于HIV患者体重信息的研究一直存在矛盾。我们于2004年6月至2005年6月在美国两家大型海军HIV诊所对男性HIV患者进行了一项回顾性研究,以描述超重/肥胖的患病率及相关因素。还将HIV阳性患者的肥胖/超重率与HIV阴性军事人员的数据进行了比较。在661名HIV感染患者中,419名(63%)超重/肥胖,只有5名(1%)体重过轻。HIV患者的平均年龄为41.0岁(范围20 - 73岁),种族多样。HIV阳性和阴性军事人员在最后一次就诊时超重/肥胖的患病率相似。最后一次诊所就诊时超重/肥胖与HIV感染过程中体重增加有关(10.4磅对4.0磅,p < 0.001)、高血压(36%对23%,p = 0.001)、低高密度脂蛋白(HDL;40%对31%,p < 0.001)以及最后一次就诊时较高的CD4细胞计数(592个对499个细胞/mm³,p < 0.001)。这些数据表明,HAART时代的HIV患者普遍超重和/或肥胖,患病率与普通人群相似。超重/肥胖与高血压和血脂异常有关。体重评估和管理项目应成为常规HIV临床护理的一部分。