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INFLAMMATION AND CHANGE IN BODY WEIGHT WITH ANTIRETROVIRAL THERAPY INITIATION IN A MULTINATIONAL COHORT OF HIV-INFECTED ADULTS
Body mass index
HIV/AIDS
HAART clinical outcomes
Noncommunicable diseases
Autor
Mave, Vidya
Erlandson, Kristine M
Gupte, Nikhil
Balagopal, Ashwin
Asmuth, David M
Campbell, Thomas B
Smeaton, Laura
Kumarasamy, Nagalingeswaran
Hakim, James
Santos, Breno
Riviere, Cynthia
Hosseinipour, Mina C
Sugandhavesa, Patcharaphan
Infante, Rosa
Pillay, Sandy
Cardoso, Sandra Wagner
Tripathy, Srikanth
Mwelase, Noluthando
Berendes, Sima
Andrade, Bruno de Bezerril
Thomas, David L
Bollinger, Robert C
Gupta, Amita
Erlandson, Kristine M
Gupte, Nikhil
Balagopal, Ashwin
Asmuth, David M
Campbell, Thomas B
Smeaton, Laura
Kumarasamy, Nagalingeswaran
Hakim, James
Santos, Breno
Riviere, Cynthia
Hosseinipour, Mina C
Sugandhavesa, Patcharaphan
Infante, Rosa
Pillay, Sandy
Cardoso, Sandra Wagner
Tripathy, Srikanth
Mwelase, Noluthando
Berendes, Sima
Andrade, Bruno de Bezerril
Thomas, David L
Bollinger, Robert C
Gupta, Amita
Afiliación
Johns Hopkins University-BJ. Medical College Clinical Research Site. Pune, India / Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
University of Colorado Denver. Department of Medicine. Denver, Aurora
Johns Hopkins University-BJ. Medical College Clinical Research Site. Pune, India / Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
University California Davis. Department of Medicine. Sacramento, USA
University of Colorado Denver. Department of Medicine. Denver, Aurora
Harvard T. H. Chan School of Public Health. Boston, Massachusetts
Y. R. Gaitonde Center for AIDS Research and Education. Chennai, India
University of Zimbabwe. Harare
Hospital Nossa Senhora de Conceição. Porto Alegre, RS, Brasil
Les Centres GHESKIO. Port-Au-Prince, Haiti
University of North Carolina Project. Lilongwe, Malawi
Research Institute for Health Sciences. Chiang Mai, Thailand
IMPACTA Peru. San Miguel
Durban University of Technology. Durban International Clinical Research Site. South Africa
Fundacao Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. STD/AIDS Clinical Research Laboratory. Rio de Janeiro, RJ, Brasil
National AIDS Research Institute. Pune, India
University of Witwatersrand. Department of Medicine. Johannesburg, South Africa
Malawi College of Medicine-Johns Hopkins University Research Project. Blantyre / Liverpool School of Tropical Medicine. United Kingdom
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Integrado de Microbiologia e Imunorregulação. Unidade de Medicina Investigativa. Salvador, BA, Brasil
Fundação José Silveira. Instituto Brasileiro para a Investigação da Tuberculose. Salvador, BA, Brasil
Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
Johns Hopkins University-BJ. Medical College Clinical Research Site. Pune, India / Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
University of Colorado Denver. Department of Medicine. Denver, Aurora
Johns Hopkins University-BJ. Medical College Clinical Research Site. Pune, India / Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
University California Davis. Department of Medicine. Sacramento, USA
University of Colorado Denver. Department of Medicine. Denver, Aurora
Harvard T. H. Chan School of Public Health. Boston, Massachusetts
Y. R. Gaitonde Center for AIDS Research and Education. Chennai, India
University of Zimbabwe. Harare
Hospital Nossa Senhora de Conceição. Porto Alegre, RS, Brasil
Les Centres GHESKIO. Port-Au-Prince, Haiti
University of North Carolina Project. Lilongwe, Malawi
Research Institute for Health Sciences. Chiang Mai, Thailand
IMPACTA Peru. San Miguel
Durban University of Technology. Durban International Clinical Research Site. South Africa
Fundacao Oswaldo Cruz. Instituto de Pesquisa Clinica Evandro Chagas. STD/AIDS Clinical Research Laboratory. Rio de Janeiro, RJ, Brasil
National AIDS Research Institute. Pune, India
University of Witwatersrand. Department of Medicine. Johannesburg, South Africa
Malawi College of Medicine-Johns Hopkins University Research Project. Blantyre / Liverpool School of Tropical Medicine. United Kingdom
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Integrado de Microbiologia e Imunorregulação. Unidade de Medicina Investigativa. Salvador, BA, Brasil
Fundação José Silveira. Instituto Brasileiro para a Investigação da Tuberculose. Salvador, BA, Brasil
Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
Johns Hopkins University-BJ. Medical College Clinical Research Site. Pune, India / Johns Hopkins University. Division of Infectious Diseases. Baltimore, Maryland
Resumen en ingles
Background. Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation during human immunodeficiency virus infection is unknown. Methods. Among a random virologically suppressed participants of the Prospective Evaluation of Antiretrovirals in Resource-
Limited Settings trial, inflammatory markers were measured at weeks 0, 24, and 48 after antiretroviral therapy (ART) initiation. Associations
between both baseline and change in body mass index (BMI; calculated as the weight in kilograms divided by the height in
meters squared) and changes in inflammation markers were assessed using random effects models.
Results. Of 246 participants, 27% were overweight/obese (BMI, ≥ 25), and 8% were underweight (BMI < 18.5) at baseline.
After 48 weeks, 37% were overweight/obese, and 3% were underweight. While level of many inflammatory markers decreased 48
weeks after ART initiation in the overall group, the decrease in C-reactive protein (CRP) level was smaller in overweight/obese participants
(P = .01), and the decreases in both CRP (P = .01) and interleukin 18 (P = .02) levels were smaller in underweight participants.
Each 1-unit gain in BMI among overweight/obese participants was associated with a 0.02-log10 increase in soluble CD14 level
(P = .05), while each 1-unit BMI gain among underweight participants was associated with a 9.32-mg/L decrease in CRP level
(P = .001).
Conclusions. Being either overweight or underweight at ART initiation was associated with heightened systemic inflammation.
While weight gain among overweight/obese persons predicted increased inflammation, weight gain among underweight persons
predicted reduced inflammation.
Palabras clave en ingles
Immune activation/inflammationBody mass index
HIV/AIDS
HAART clinical outcomes
Noncommunicable diseases
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