Changes in Body Mass Index Among Antiretroviral Therapy Naïve People Living with HIV in Southeastern Nigeria

John O Olawepo,Jennifer R Pharr,Chinedu Aniekwe,Chad L Cross,Babayemi O Olakunde,Raisa Kabir,Ayodotun Olutola,Mercy Niyang

doi:10.5539/gjhs.v13n6p14

John O Olawepo, Jennifer R Pharr + Show 6 more

Open Access

https://doi.org/10.5539/gjhs.v13n6p14

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Abstract

The proportion of people living with HIV (PLHIV) who are overweight or obese is rising, leading to a double epidemic of HIV and obesity. The purpose of this retrospective longitudinal study was to examine changes in body mass index (BMI) among PLHIV who were new to antiretroviral therapy (ART) in two states in Southeastern Nigeria. The BMI at baseline and 12 months were compared and the difference in proportions in each BMI category was tested. The association between the BMI at 12 months and the demographic and/or clinical variables was examined using multiway analysis of covariance. The study included 2,146 participants. After 12 months on ART, the number of participants who were obese increased by 135% (81 to 190), while those who were underweight decreased by 130% (306 to 133). Overall, the BMI increased in 30.2% of the participants. Further analysis showed that age (p=.009; &eta;2=.005), baseline BMI (p&lt;.001; &eta;2=.435), baseline regimen (p&lt;.001; &eta;2=.031), HIV stage (p=.039; &eta;2=.007) and CD4 category (p&lt;.001; &eta;2=.012) were all associated with increased BMI after 12 months of ART. Healthcare providers should be mindful of the likelihood of excess weight gain among PLHIV who are on ART and develop a plan to proactively address it.

Highlights

People living with HIV (PLHIV) are living longer and this longevity is increasingly associated with the diagnosis of other chronic health conditions like obesity, cardiovascular diseases, and cancer (Lerner et al, 2019; Marcus et al, 2020; Tate et al, 2012)
Healthcare providers should be mindful of the likelihood of excess weight gain among people living with HIV (PLHIV) who are on antiretroviral therapy (ART) and develop a plan to proactively address it
This study examined changes in body mass index (BMI) from baseline to 12 months in 2,146 ART naïve PLHIV who participated in a free HIV care and treatment program in southeastern Nigeria between 2012 and 2015

Summary

Introduction

People living with HIV (PLHIV) are living longer and this longevity is increasingly associated with the diagnosis of other chronic health conditions like obesity, cardiovascular diseases, and cancer (Lerner et al, 2019; Marcus et al, 2020; Tate et al, 2012). In Nigeria, Africa’s most populated nation, a systematic review reported an overweight prevalence of 20-35%, and obesity prevalence of 8-22% among adults (Chukwuonye et al, 2013). The 2018 Nigeria Demographic and Health Survey (DHS) reported the prevalence of overweight among women in the southeastern region to be 23.4% and the prevalence of obesity to be 16.1% (National Population Commission [NPC] and ICF, 2019)

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