Obesity in the HIV-infected population in Northeast England: a particular issue in Black-African women

2016 ◽  
Vol 28 (3) ◽  
pp. 284-289 ◽  
Author(s):  
C Ilozue ◽  
B Howe ◽  
S Shaw ◽  
K Haigh ◽  
J Hussey ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Local Population ◽  
African Women ◽  
People Living With Hiv ◽  
Black African ◽  
Regional Population ◽  
Living With Hiv

People living with HIV are surviving longer on successful antiretroviral therapy and obesity rates are increasing. We sought to determine the prevalence of being overweight or obese in a regional population of people living with HIV and to explore the demographic and clinical characteristics associated with obesity or being overweight. Data on patients attending three Northeast England clinics were collected including body mass index and demographics. The prevalence of being overweight (body mass index ≥ 25 kg/m2) or obese (body mass index ≥ 30 kg/m2) was determined and compared with regional population data. Associations between being overweight or obese and demographic and other data were further explored using logistic regression models. In 560 patients studied (median age 45 years, 26% Black-African and 69% male), 65% were overweight/obese and 26% obese, which is similar to the local population. However, 83% and 48% of Black-African women were overweight/obese or obese, respectively, with 11% being morbidly obese (body mass index > 40 kg/m2). In the multivariate analyses, the only factors significantly associated with obesity were Black-African race (adjusted odds ratio 2.78, 95% confidence interval 1.60–4.85) and type 2 diabetes (adjusted odds ratio 4.23, 95% confidence interval 1.81–9.91). Levels of obesity and overweight in people living with HIV are now comparable to the levels in the local population of Northeast England; however, the prevalence is significantly higher in Black-African women. Given the additional risk factors for cardiovascular disease inherent in people living with HIV, better strategies to prevent, identify and manage obesity in this population are needed.

Comparison of Clinical Outcomes of Persons Living With HIV by Enrollment Status in Washington, DC: Evaluation of a Large Longitudinal HIV Cohort Study (Preprint)

2019 ◽  
Author(s):  
Jenevieve Opoku ◽  
Rupali K Doshi ◽  
Amanda D Castel ◽  
Ian Sorensen ◽  
Michael Horberg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Outcomes ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Hiv Care ◽  
Disease Stage ◽  
People Living With Hiv ◽  
Hiv Disease ◽  
Persons Living With Hiv ◽  
Living With Hiv

BACKGROUND HIV cohort studies have been used to assess health outcomes and inform the care and treatment of people living with HIV disease. However, there may be similarities and differences between cohort participants and the general population from which they are drawn. OBJECTIVE The objective of this analysis was to compare people living with HIV who have and have not been enrolled in the DC Cohort study and assess whether participants are a representative citywide sample of people living with HIV in the District of Columbia (DC). METHODS Data from the DC Health (DCDOH) HIV surveillance system and the DC Cohort study were matched to identify people living with HIV who were DC residents and had consented for the study by the end of 2016. Analysis was performed to identify differences between DC Cohort and noncohort participants by demographics and comorbid conditions. HIV disease stage, receipt of care, and viral suppression were evaluated. Adjusted logistic regression assessed correlates of health outcomes between the two groups. RESULTS There were 12,964 known people living with HIV in DC at the end of 2016, of which 40.1% were DC Cohort participants. Compared with nonparticipants, participants were less likely to be male (68.0% vs 74.9%, <i>P</i>&lt;.001) but more likely to be black (82.3% vs 69.5%, <i>P</i>&lt;.001) and have a heterosexual contact HIV transmission risk (30.3% vs 25.9%, <i>P</i>&lt;.001). DC Cohort participants were also more likely to have ever been diagnosed with stage 3 HIV disease (59.6% vs 47.0%, <i>P</i>&lt;.001), have a CD4 &lt;200 cells/µL in 2017 (6.2% vs 4.6%, <i>P</i>&lt;.001), be retained in any HIV care in 2017 (72.9% vs 59.4%, <i>P</i>&lt;.001), and be virally suppressed in 2017. After adjusting for demographics, DC Cohort participants were significantly more likely to have received care in 2017 (adjusted odds ratio 1.8, 95% CI 1.70-2.00) and to have ever been virally suppressed (adjusted odds ratio 1.3, 95% CI 1.20-1.40). CONCLUSIONS These data have important implications when assessing the representativeness of patients enrolled in clinic-based cohorts compared with the DC-area general HIV population. As participants continue to enroll in the DC Cohort study, ongoing assessment of representativeness will be required.

Influence of nutritional status and gastrointestinal symptoms on sleep quality in people living with HIV

2019 ◽  
Vol 30 (9) ◽  
pp. 885-890
Author(s):  
Luciana Fidalgo Ramos Nogueira ◽  
Thais Carvalho da Fonseca ◽  
Patrick Herman Paterlini ◽  
Adriana de Sousa Duarte ◽  
Pollyanna Pellegrino ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Sleep Quality ◽  
Body Mass ◽  
Sleep Problems ◽  
Care Service ◽  
Gastrointestinal Symptoms ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Self Reporting Questionnaire

Sleep problems are frequent among people living with HIV (PLWH). Recent studies have found that inadequate nutritional status and presence of gastrointestinal symptoms are associated with sleep problems. Therefore, the objective of the present study was to evaluate the influence of nutritional status and gastrointestinal symptoms on sleep quality in PLWH receiving antiretroviral therapy (ART). A cross-sectional study evaluating the influence of nutritional and gastrointestinal aspects on the quality of sleep in 307 PLWH (age ≥18 years) receiving ART seen at the Specialized Care Service of Santos (SP, Brazil) was carried out. The Pittsburgh Sleep Quality Index (PSQI), body mass index and three questions from the Self-Reporting Questionnaire (SRQ-20) were used. Generalized linear models adjusted for gender, age, time in use of antiretrovirals, viral load, CD4+ T-lymphocyte cell count and CD4/CD8 ratio were built. Results showed that body mass index did not affect sleep quality. However, the interaction between poor appetite and not having poor digestion and uncomfortable feelings in the stomach negatively influenced sleep quality. The interaction of the three symptoms evaluated also affected sleep quality. Gastrointestinal symptoms were associated with reduced sleep quality, but there was no influence of BMI. Although the etiology of this relationship is unclear, there seems to be an important association between sleep quality, immune function and gastrointestinal disorders.

scholarly journals FGF23 and Left Ventricular Hypertrophy in Children with CKD

2017 ◽  
Vol 13 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Mark M. Mitsnefes ◽  
Aisha Betoko ◽  
Michael F. Schneider ◽  
Isidro B. Salusky ◽  
Myles Selig Wolf ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Left Ventricular Hypertrophy ◽  
Confidence Interval ◽  
Body Mass ◽  
Odds Ratio ◽  
Ventricular Hypertrophy ◽  
Adjusted Odds Ratio ◽  
Fibroblast Growth Factor 23 ◽  
Left Ventricular ◽  
Interquartile Range

Background and ObjectivesHigh plasma concentration of fibroblast growth factor 23 (FGF23) is a risk factor for left ventricular hypertrophy (LVH) in adults with CKD, and induces myocardial hypertrophy in experimental CKD. We hypothesized that high FGF23 levels associate with a higher prevalence of LVH in children with CKD.Design, setting, participants, & measurementsWe performed echocardiograms and measured plasma C-terminal FGF23 concentrations in 587 children with mild-to-moderate CKD enrolled in the Chronic Kidney Disease in Children (CKiD) study. We used linear and logistic regression to analyze the association of plasma FGF23 with left ventricular mass index (LVMI) and LVH (LVMI ≥95th percentile), adjusted for demographics, body mass index, eGFR, and CKD-specific factors. We also examined the relationship between FGF23 and LVH by eGFR level.ResultsMedian age was 12 years (interquartile range, 8–15) and eGFR was 50 ml/min per 1.73 m2 (interquartile range, 38–64). Overall prevalence of LVH was 11%. After adjustment for demographics and body mass index, the odds of having LVH was higher by 2.53 (95% confidence interval, 1.28 to 4.97; P<0.01) in participants with FGF23 concentrations ≥170 RU/ml compared with those with FGF23<100 RU/ml, but this association was attenuated after full adjustment. Among participants with eGFR≥45 ml/min per 1.73 m2, the prevalence of LVH was 5.4%, 11.2%, and 15.3% for those with FGF23 <100 RU/ml, 100–169 RU/ml, and ≥170 RU/ml, respectively (Ptrend=0.01). When eGFR was ≥45 ml/min per 1.73 m2, higher FGF23 concentrations were independently associated with LVH (fully adjusted odds ratio, 3.08 in the highest versus lowest FGF23 category; 95% confidence interval, 1.02 to 9.24; P<0.05; fully adjusted odds ratio, 2.02 per doubling of FGF23; 95% confidence interval, 1.29 to 3.17; P<0.01). By contrast, in participants with eGFR<45 ml/min per 1.73 m2, FGF23 did not associate with LVH.ConclusionsPlasma FGF23 concentration ≥170 RU/ml is an independent predictor of LVH in children with eGFR≥45 ml/min per 1.73 m2.

scholarly journals Disclosure of HIV seropositivity to sexual partner in Ethiopia: A systematic review

2021 ◽  
Vol 17 ◽  
pp. 174550652110630
Author(s):  
Aklilu Endalamaw ◽  
Yibeltal Assefa ◽  
Demeke Geremew ◽  
Habte Belete ◽  
Berihun Assefa Dachew ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Sexual Partners ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Living With Hiv ◽  
Status Disclosure ◽  
The Impact

Introduction: In Ethiopia, the burden of HIV/AIDS is a public health issue that requires significant control of transmission. Once an infection has been established, determinants influence people living with HIV to disclose or not their HIV-positive status to sexual partners. This study assessed the proportion and associated factors of people living with HIV’s disclosure status to sexual partners. Methods: CRD42020149092 is the protocol’s registration number in the PROSPERO database. We searched PubMed, Scopus, African Journals Online, and Google Scholar databases. For the subjective and objective assessment of publication bias, we used a funnel plot and Egger’s regression test, respectively. The I2 statistic was used to assess variation across studies. Meta-analysis of weighted inverse variance random-effects model was used to estimate the pooled proportion. We conducted subgroup and sensitivity analyses to investigate the cause of heterogeneity and the impact of outliers on the overall estimation, respectively. A trend analysis was also performed to show the presence of time variation. Results: The percentage of people living with HIV who disclosed their HIV-positive status to sexual partners was 76.03% (95% confidence interval: 68.78, 83.27). Being on antiretroviral therapy (adjusted odds ratio = 6.19; 95% confidence interval: 2.92, 9.49), cohabiting with partner (adjusted odds ratio = 4.48; 95% confidence interval: 1.24, 7.72), receiving HIV counseling (adjusted odds ratio = 3.94; 95% confidence interval: 2.08, 5.80), having discussion prior to HIV testing (adjusted odds ratio = 4.40; 95% confidence interval: 2.11, 6.69), being aware of partner’s HIV status (adjusted odds ratio = 6.08; 95% confidence interval: 3.05, 9.10), positive relationship with partner (adjusted odds ratio = 4.44; 95% confidence interval:1.28, 7.61), and being member of HIV association (adjusted odds ratio = 3.70; 95% confidence interval: 2.20, 5.20) had positive association with HIV status disclosure. Conclusion: In Ethiopia, more than one-fourth of adults living with HIV did not disclose their HIV-positive status to sexual partners. HIV-positive status disclosure was influenced by psychosocial factors. A multidimensional approach is required to increase seropositive disclosure in Ethiopia.

scholarly journals The effects of nutritional supplementation on body mass index and CD4 count among adult people living with HIV AIDS on antiretroviral treatment in Conakry, Guinea

2018 ◽  
Author(s):  
Sidikiba Sidibé ◽  
Alexandre Delamou ◽  
Mohamed Lamine Kaba ◽  
Aboubacar Sidiki Magassouba ◽  
Amara Tabaouo Samake ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Nutritional Supplementation ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Average Current ◽  
Nutrition Assistance ◽  
Study Sites ◽  
Study Participants ◽  
Living With Hiv

Whereas the HIV prevalence in Guinea is among the lowest in Africa, many PLHIV in Guinea are malnourished. This study assessed the effect of a nutritional supplementation program on body mass index and CD4 count among adult PLHIV on ART. Study participants were PLHIV who came for consultation in the study sites between May and July 2016. The data came from two sources: retrospectively from participants’ medical records and interviews at the time of recruitment into the study. About six months before they were recruited into the study, some of the PLHIV started to receive a monthly nutritional supplementation consisting of Corn-Soy Blend and oil. Analytic methods included bivariate and multivariable methods. The intervention increased the mean BMI by 7.4% and the average current CD4 count by 4.7% compared to nonintervention (P<0.001). Programs in low resource settings should consider nutrition assistance as part of a comprehensive strategy to ensure optimal metabolic and immunological functions among PLHIV.

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

2021 ◽  
Vol 13 (6) ◽  
pp. 14
Author(s):  
John O. Olawepo ◽  
Jennifer R. Pharr ◽  
Chad L. Cross ◽  
Babayemi O. Olakunde ◽  
Chinedu Aniekwe ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Antiretroviral Therapy ◽  
Body Mass ◽  
Healthcare Providers ◽  
Analysis Of Covariance ◽  
People Living With Hiv ◽  
Southeastern Nigeria ◽  
The Difference ◽  
Living With Hiv ◽  
Baseline Bmi

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.

scholarly journals Comparison of Clinical Outcomes of Persons Living With HIV by Enrollment Status in Washington, DC: Evaluation of a Large Longitudinal HIV Cohort Study

10.2196/16061 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e16061
Author(s):  
Jenevieve Opoku ◽  
Rupali K Doshi ◽  
Amanda D Castel ◽  
Ian Sorensen ◽  
Michael Horberg ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Outcomes ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Hiv Care ◽  
Disease Stage ◽  
People Living With Hiv ◽  
Hiv Disease ◽  
Persons Living With Hiv ◽  
Living With Hiv

Background HIV cohort studies have been used to assess health outcomes and inform the care and treatment of people living with HIV disease. However, there may be similarities and differences between cohort participants and the general population from which they are drawn. Objective The objective of this analysis was to compare people living with HIV who have and have not been enrolled in the DC Cohort study and assess whether participants are a representative citywide sample of people living with HIV in the District of Columbia (DC). Methods Data from the DC Health (DCDOH) HIV surveillance system and the DC Cohort study were matched to identify people living with HIV who were DC residents and had consented for the study by the end of 2016. Analysis was performed to identify differences between DC Cohort and noncohort participants by demographics and comorbid conditions. HIV disease stage, receipt of care, and viral suppression were evaluated. Adjusted logistic regression assessed correlates of health outcomes between the two groups. Results There were 12,964 known people living with HIV in DC at the end of 2016, of which 40.1% were DC Cohort participants. Compared with nonparticipants, participants were less likely to be male (68.0% vs 74.9%, P<.001) but more likely to be black (82.3% vs 69.5%, P<.001) and have a heterosexual contact HIV transmission risk (30.3% vs 25.9%, P<.001). DC Cohort participants were also more likely to have ever been diagnosed with stage 3 HIV disease (59.6% vs 47.0%, P<.001), have a CD4 <200 cells/µL in 2017 (6.2% vs 4.6%, P<.001), be retained in any HIV care in 2017 (72.9% vs 59.4%, P<.001), and be virally suppressed in 2017. After adjusting for demographics, DC Cohort participants were significantly more likely to have received care in 2017 (adjusted odds ratio 1.8, 95% CI 1.70-2.00) and to have ever been virally suppressed (adjusted odds ratio 1.3, 95% CI 1.20-1.40). Conclusions These data have important implications when assessing the representativeness of patients enrolled in clinic-based cohorts compared with the DC-area general HIV population. As participants continue to enroll in the DC Cohort study, ongoing assessment of representativeness will be required.

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