Abstract
BackgroundUnderweight in human immunodeficiency virus (HIV)-infected people on antiretroviral therapy (ART) complicates the management of HIV infection and contributes to mortality, whereas overweight increases the risk of cardiovascular disease (CVD).AimThe study determined weight status and associated factors in people with HIV infection receiving ART.SettingRural primary health care clinics in Dikgale, Limpopo province, South Africa.MethodsA cross-sectional study in which data were collected using the World Health Organization (WHO) stepwise approach to surveillance (STEPS) questionnaire and calculated using WHO analysis programmes guide. Weight and height were measured using standard WHO procedures, and body mass index was calculated as weight (kg)/height (m2). Data on ART duration were extracted from patients’ files. CD4 lymphocyte counts and viral load were determined using standard laboratory techniques.ResultsOf the 214 participants, 8.9%, 54.7% and 36.4% were underweight, normal weight and overweight, respectively. Physical activity (OR: 0.99, p = 0.001) and male gender (OR: 0.29, p = 0.04) were negatively associated with overweight. Men who used tobacco were more likely to be underweight than non-tobacco users (OR: 10.87, p = 0.02). Neither ART duration nor viral load or CD4 count was independently associated with underweight or overweight in multivariate analysis.ConclusionA high proportion of people on ART were overweight and a smaller proportion underweight. There is a need to simultaneously address the two extreme weight problems in this vulnerable population through educating them on benefits of avoiding tobacco, engaging in physical activity and raising awareness of CVD risk.
Highlights
Underweight in human immunodeficiency virus (HIV)-infected people on antiretroviral therapy (ART) complicates the management of HIV infection and contributes to mortality, whereas overweight increases the risk of cardiovascular disease (CVD)
The increase in weight among HIV-infected people on ART has been attributed to a state of return to health in which appetite is gained and more food consumed, coupled with low physical activity.[1]
Weight gain in people on ART has been characterized by dorsocervical fat pad and visceral fat accumulation that may increase the risk of coronary artery disease.[2]
Summary
Underweight in human immunodeficiency virus (HIV)-infected people on antiretroviral therapy (ART) complicates the management of HIV infection and contributes to mortality, whereas overweight increases the risk of cardiovascular disease (CVD). Overweight is a growing public health problem among HIV-infected people on ART, as observed in the general populations worldwide.[1] The increase in weight among HIV-infected people on ART has been attributed to a state of return to health in which appetite is gained and more food consumed, coupled with low physical activity.[1] Weight gain in people on ART has been characterized by dorsocervical fat pad and visceral fat accumulation that may increase the risk of coronary artery disease.[2] the relatively high percentage of people on ART that are underweight is still a concern.[3] Being overweight or underweight may increase the risk of cardiovascular diseases.[4,5]. The developed world is faced with an increasing problem of overweight among HIVinfected people on ART,[6,7] the developing world is experiencing a double burden of underweight and overweight.[8,9,10] the prevalence of underweight and overweight reported from African countries is different,[8,9,10] possibly due to differences in ART regimen, duration of ART and socio-economic factors.[2]
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