Guehi Calixte, Badjé Anani, Gabillard Delphine, Ouattara Eric, Koulé Serge Olivier, Moh Raoul, Ekouevi Didier, Ahibo Hugues, N'Takpé Jean Baptiste, Menan Gérard Kouamé, Deschamps Nina, Lecarrou Jerôme, Eholié Serge, Anglaret Xavier, Danel Christine
Unité de Soins Ambulatoire et de Conseil (USAC), 18 BP, 1125 Abidjan 18, Côte d'Ivoire.
Programme PACCI, ANRS research Site, Abidjan, Côte d'Ivoire ; Inserm U 1219, Bordeaux University, Bordeaux, France.
AIDS Res Ther. 2016 Feb 25;13:12. doi: 10.1186/s12981-016-0094-y. eCollection 2016.
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.
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.
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).
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.
HIV通常与体重减轻有关。世界卫生组织（WHO）建议尽早开始抗逆转录病毒治疗（ART），但在非洲，关于早期开始ART的参与者体重指数（BMI）变化的数据很少。
在阿比让进行了Temprano随机试验，以评估早期ART和异烟肼（INH）预防HIV感染且CD4细胞计数高（低于800个细胞/mm³）且无任何开始ART指征的患者患结核病的有效性。2010年12月前开始早期ART的患者纳入本亚组研究。BMI分为：体重过轻（<18.5kg/m²）、正常体重（18.5 - 24.9kg/m²）、超重（25 - 29.9kg/m²）和肥胖（≥30kg/m²）。在基线和ART治疗24个月后，使用单因素和多因素逻辑回归估计超重或肥胖的患病率以及与超重或肥胖相关的因素。
基线时，755名参与者（78%为女性；CD4细胞计数中位数为442/mm³，基线BMI中位数为22kg/m²）开始ART。其中，19.7%为超重，7.2%为肥胖。与超重或肥胖相关的因素有：女性，调整后比值比（aOR）为2.3（95%置信区间[CI]为1.4 - 3.7）；年龄，每5岁的aOR为1.01（95%CI为1.0 - 1.2）；生活条件优越，aOR为2.6（95%CI为1.5 - 4.4）；高血压，aOR为4.3（95%CI为2.0 - 9.2）；WHO分期2对比1，aOR为0.7（95%CI为0.4 - 1.0）；血红蛋白≥95g/dl，aOR为3.0（95%CI为1.6 - 5.8）。在597名参加M24随访的患者中，超重或肥胖率分别从20.4%增至24.8%（p = 0.01）和7.2%增至9.2%（p = 0.03），与超重或肥胖相关的因素是免疫反应，以M0 - M24期间CD4细胞计数增加来衡量（每增加50个细胞/mm³：aOR为1.01；95%CI为1.05 - 1.13，p = 0.01）。
在基线时CD4细胞计数高的HIV感染者中，超重和肥胖类别非常普遍，在撒哈拉以南非洲人群中，接受ART治疗24个月后超重和肥胖率有所增加。
