Lai Shih-Wei, Lin Cheng-Li, Liao Kuan-Fu
College of Medicine, China Medical University, Taichung 404, Taiwan - Department of Family Medicine, China Medical University Hospital, Taichung 404, Taiwan.
College of Medicine, China Medical University, Taichung 404, Taiwan - Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan.
Biomedicine (Taipei). 2018 Sep;8(3):19. doi: 10.1051/bmdcn/2018080319. Epub 2018 Aug 24.
BACKGROUND/OBJECTIVE: Little research is available on the relationship between weight loss and human immunodeficiency virus (HIV) infection in Taiwan. We hope to evaluate whether weight loss could be an early clinical feature of undiagnosed HIV infection in Taiwan.
We conducted a retrospective population-based cohort study using the database of the Taiwan National Health Insurance (NHI) Program. There were 4748 male subjects aged 1-84 with newly diagnosed weight loss as the weight loss group from 1998-2012 and 18982 age-matched male subjects without weight loss as the non-weight loss group. The incidence of HIV infection at the end of 2013 was measured in both groups. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for HIV risk associated with weight loss.
The overall incidence of HIV infection was 3.79-fold higher in the weight loss group than in the non-weight loss group (6.83 vs. 1.80 per 10000 person-years, 95% CI 3.41, 4.21). The incidence was the highest during the first 6 months of follow-up in the weight loss group (39.0 per 10000 person-years). After adjusting for confounding factors, the adjusted HR of HIV infection was 3.63 (95% CI 1.77, 7.44) for the weight loss group, compared with the non-weight loss group.
Weight loss might be an early clinical feature of undiagnosed HIV infection in Taiwan. Male patients with weight loss who have risk factors for HIV infection should be recommended to regularly be tested for HIV infection.
背景/目的：台湾关于体重减轻与人类免疫缺陷病毒（HIV）感染之间关系的研究较少。我们希望评估体重减轻是否可能是台湾未诊断出的HIV感染的早期临床特征。
我们利用台湾国民健康保险（NHI）计划的数据库进行了一项基于人群的回顾性队列研究。有4748名年龄在1至84岁之间的男性受试者，他们在1998年至2012年期间被新诊断为体重减轻，作为体重减轻组，另有18982名年龄匹配的无体重减轻的男性受试者作为非体重减轻组。在2013年底测量了两组中HIV感染的发生率。使用多变量Cox比例风险回归模型来测量与体重减轻相关的HIV风险的风险比（HR）和95%置信区间（CI）。
体重减轻组中HIV感染的总体发生率比非体重减轻组高3.79倍（每10000人年6.83例 vs. 1.80例，95% CI 3.41, 4.21）。体重减轻组在随访的前6个月内发生率最高（每10000人年39.0例）。在调整混杂因素后，与非体重减轻组相比，体重减轻组HIV感染的调整后HR为3.63（95% CI 1.77, 7.44）。
体重减轻可能是台湾未诊断出的HIV感染的早期临床特征。对于有HIV感染风险因素的体重减轻男性患者，应建议定期进行HIV感染检测。
