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Relationship between Body Mass Index and Mortality in HIV-Infected HAART Users in the Women's Interagency HIV Study

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Title: Relationship between Body Mass Index and Mortality in HIV-Infected HAART Users in the Women's Interagency HIV Study
Author(s): Sharma, A.; Hoover, D. R.; Shi, Q. H.; Gustafson, D.; Plankey, M. W.; Hershow, R. C.; Tien, P. C.; Golub, E. T.; Anastos, K.
Subject(s): antiretrovirus agent body mass HAART Interagency HIV Study
Abstract: Background Early HIV studies suggested protective associations of overweight against mortality, yet data are lacking for the era of potent highly active antiretroviral therapy (HAART). We evaluated associations of pre-HAART initiation body mass index (BMI) with mortality among HAART-using women. Methods Prospective study of time to death after HAART initiation among continuous HAART users in the Women's Interagency HIV Study. Unadjusted Kaplan Meier and adjusted proportional hazards survival models assessed time to AIDS and non-AIDS death by last measured pre-HAART BMI. Results Of 1428 continuous HAART users 39 (2.7%) were underweight, 521 (36.5%) normal weight, 441 (30.9%) overweight, and 427 (29.9%) obese at time of HAART initiation. A total of 322 deaths occurred during median follow-up of 10.4 years (IQR 5.9 14.6). Censoring at non-AIDS death, the highest rate of AIDS death was observed among underweight women (p = 0.0003 for all 4 categories). In multivariate models, women underweight prior to HAART died from AIDS more than twice as rapidly vs. normal weight women (aHR 2.04, 95% CI 1.03, 4.04); but being overweight or obese (vs. normal weight) was not independently associated with AIDS death. Cumulative incidence of non-AIDS death was similar across all pre-HAART BMI categories. Conclusions Among continuous HAART-using women, being overweight prior to initiation was not associated with lower risk of AIDS or non-AIDS death. Being underweight prior to HAART was associated with over double the rate of AIDS death in adjusted analyses. Although overweight and obesity may be associated with many adverse health conditions, neither was predictive of mortality among the HAART-using women.
Issue Date: 2015-12-01
Publisher: Public Library of Science
Citation Info: Sharma, A., Hoover, D. R., Shi, Q. H., Gustafson, D., Plankey, M. W., Hershow, R. C., Tien, P. C., Golub, E. T. and Anastos, K. Relationship between Body Mass Index and Mortality in HIV-Infected HAART Users in the Women's Interagency HIV Study. PLoS One. 2015. 10(12). DOI: 10.1371/journal.pone.0143740.
Type: Article
Description: This is a copy of an article published in the PLoS ONE. © 2015 Sharma et al.
URI: http://hdl.handle.net/10027/21141
ISSN: 1932-6203
Sponsor: The WIHS is funded by the National Institute of Allergy and Infectious Diseases (UO1-AI- 35004, UO1-AI-31834, UO1-AI-34994, UO1-AI- 34989, UO1-AI-34993, and UO1-AI-42590) and by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (UO1-HD-32632).
Date Available in INDIGO: 2016-09-12
 

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