Predictors of Weight Change in Male HIV-Positive Injection Drug Users Initiating Antiretroviral Therapy in Hanoi, Vietnam

Alice M Tang,Dang Van Duong,Norma Terrin,Trinh Thi Minh Lien,Nguyen Vu Trung,Christine A Wanke,Michael R Jordan,Kimberly Dong,Nguyen Duc Hien,Heidi B Sheehan

doi:10.1155/2011/890308

Abstract

We examined clinical and nutritional predictors of weight change over two consecutive 6-month intervals among 99 HIV-positive male injection drug users initiating antiretroviral therapy (ART) in Hanoi, Vietnam. The average weight gain was 3.1 ± 4.8 kg in the first six months after ART and 0.8 ± 3.0 kg in the following six months. Predictors of weight change differed by interval. In the first interval, CD4 < 200 cells/μL, excellent/very good adherence to ART, bothersome nausea, and liquid supplement use were all associated with positive weight changes. Moderate to heavy alcohol use and tobacco smoking were associated with negative weight changes. In the second interval, having a CD4 count <200 cells/μL at the beginning of the interval and tobacco smoking were the only significant predictors and both were associated with negative weight changes. We identified several potential areas for interventions to promote weight gain immediately after starting ART in this population. Studies are needed to determine whether improving weight prior to, or at, ART initiation will result in improved outcomes on ART.

Highlights

Access to antiretroviral treatment (ART) has expanded rapidly in many moderate-to low-income countries affected by the HIV epidemic
We examined clinical and nutritional predictors of weight change over two consecutive 6-month intervals among 99 HIV-positive male injection drug users initiating antiretroviral therapy (ART) in Hanoi, Vietnam
Studies are needed to determine whether improving weight prior to, or at, ART initiation will result in improved outcomes on ART

Summary

Introduction

Access to antiretroviral treatment (ART) has expanded rapidly in many moderate-to low-income countries affected by the HIV epidemic. Several large-scale ART programs in sub-Saharan Africa indicate that malnutrition (low BMI) at the start of ART is significantly and independently associated with subsequent mortality [3,4,5,6], while weight gain after ART is associated with survival [7, 8]. It is unclear whether this association is causal. In Vietnam, the number of PLHIV is estimated to be 293,000 with an HIV prevalence rate of 0.53% among adults [9]. No studies are published on the nutritional outcomes of ART initiation in Vietnam

Methods

Results

Conclusion