Weight status in HIV‐positive women after termination of a drug and lipid‐based nutrient supplement intervention is predicted by food availability and health

Abstract

This study examined weight status in HIV‐positive Malawian mothers after they completed an antiretroviral (ARV) and nutritional supplement intervention. Women in the Breastfeeding, Antiretrovirals, and Nutrition study (n=2369) received either lipid‐based nutrient supplements (LNS) to prevent maternal depletion or no LNS and were further randomized to receive ARVs to prevent HIV transmission or no ARVs from delivery through 24 wks of exclusive breastfeeding and 4 wks of rapid weaning. All women received a 2 kg/wk family maize supplement and enhanced standard of care for 48 wks. Women on ARVs entered rapid weaning with a lower mean BMI than the other groups and had negligible weight change (<0.3 kg) in the subsequent 24 wks, while women in the LNS, no ARVs group lost weight (−1.0 kg) post‐supplementation. Termination of ARVs and LNS had no serious consequences for maternal weight status: <4% of women lost >10% weight from wks 24 to 48. A longitudinal random effects model controlling for 24 wk BMI showed that vomiting (p<0.01), diarrhea (p<0.01), oral thrush (p<0.05), hungry season (p<0.01), and famine year of 2005 (p=0.02) were negatively associated with weight, while CD4 count (p<0.01) was positively associated with weight. Thus, the key predictors of weight status in this population were food availability and health status.Support: CDC (U48‐DP000059‐01); Gates Foundation (OPP53107); CPC (NICHD 5 R24 HD050924)