Garcia Jose M, Dong Yongquan, Richardson Peter, Kramer Jennifer R, Hartman Christine M, Royse Kathryn, White Donna L, Chiao Elizabeth Y
Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, and Department of Medicine, Division of Gerontology & Geriatric Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
VA Health Services Research Center of Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas, USA.
HIV Med. 2023 Feb;24(2):180-190. doi: 10.1111/hiv.13366. Epub 2022 Aug 5.
People living with HIV have high rates of obesity and obesity-related comorbidities. Our study sought to evaluate weight trajectory in a retrospective cohort of people living with HIV and matched HIV-negative veterans (controls) and to evaluate risk factors for weight gain.
This was a retrospective database analysis of data extracted from the VA Corporate Data Warehouse that included people living with HIV (n = 22 421) and age-matched HIV-negative controls (n = 63 072). The main outcomes were baseline body weight and weight change from baseline at 1, 2, and 5 years after diagnosis (baseline visit for controls).
Body weight at baseline was lower in people living with HIV than in controls. People living with HIV on antiretroviral therapy (ART) gained more weight than did controls. In a sub-analysis of ART-exposed people living with HIV, age >50 years, African American race, body mass index (BMI) <25, CD4 ≤200, and HIV diagnosis year after 2000 were associated with more weight gain at year 1. Nucleoside reverse transcriptase inhibitors (NRTI) plus non-NRTIs (NNRTIs) were associated with less weight gain than NRTIs plus protease inhibitors, NRTIs plus integrase inhibitors, or NRTIs plus other agents at year 1.
Among US veterans, those living with HIV had lower rates of obesity than age-matched HIV-negative controls; however, primarily in the first 2 years after starting ART, people living with HIV gained more weight than did controls.
感染艾滋病毒的人群肥胖及肥胖相关合并症的发生率较高。我们的研究旨在评估一组感染艾滋病毒的回顾性队列以及匹配的艾滋病毒阴性退伍军人（对照组）的体重变化轨迹，并评估体重增加的风险因素。
这是一项对从退伍军人事务部企业数据仓库中提取的数据进行的回顾性数据库分析，该数据包括感染艾滋病毒的人群（n = 22421）和年龄匹配的艾滋病毒阴性对照组（n = 63072）。主要结局指标为基线体重以及诊断后1年、2年和5年时相对于基线的体重变化（对照组为基线访视）。
感染艾滋病毒者的基线体重低于对照组。接受抗逆转录病毒疗法（ART）的感染艾滋病毒者比对照组体重增加更多。在对接受ART治疗的感染艾滋病毒者的亚分析中，年龄>50岁、非裔美国人种族、体重指数（BMI）<25、CD4≤200以及2000年后诊断为艾滋病毒与第1年体重增加更多相关。在第1年，核苷类逆转录酶抑制剂（NRTI）加非核苷类逆转录酶抑制剂（NNRTI）与体重增加少于NRTI加蛋白酶抑制剂、NRTI加整合酶抑制剂或NRTI加其他药物相关。
在美国退伍军人中，感染艾滋病毒者的肥胖率低于年龄匹配的艾滋病毒阴性对照组；然而，主要在开始ART治疗后的头2年，感染艾滋病毒者比对照组体重增加更多。
