Inflammation and change in body weight with antiretroviral therapy initiation in a multinational cohort of HIV-infected adults
Citation: Mave V, Erlandson KM, Gupte N, Balgopal A, Asmuth DM, Campbell TB, Smeaton L, Kumarasamy N, Hakim J, Santos B, Riviere C, Hosseinipour MC, Sugandhavesa P, Infante R, Pillay S, Cardoso SW, Tripathy S, Mwelase N, Berendes S, Andrade BB, Thomas DL, Bollinger RC, Gupta A, and the ACTG PEARLS and NWCS 319 Study Team. Inflammation and change in body weight with antiretroviral therapy initiation in a multinational cohort of HIV-infected adults. J Infect Dis. 2016 Jul 1;214(1):65-72. doi: 10.1093/infdis/jiw096. Epub 2016 Mar 8. PMID: 26962236. PMCID: PMC4907416.
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https://www.ncbi.nlm.nih.gov/pubmed/26962236
Background
Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation in HIV is unknown.
Methods
Among a random virologically suppressed participants of the PEARLS trial, inflammatory markers were measured at weeks 0, 24, and 48 post-antiretroviral therapy (ART). Associations between baseline and change in body mass index (BMI) and inflammation changes were assessed using random effects models.
Results
Of 246 participants, 27% were overweight/obese (BMI≥25 kg/m2) and 8% were underweight (BMI<18.5 kg/m2) at baseline. After 48 weeks, 37% were overweight/obese and 3% were underweight. While many inflammatory markers decreased 48 weeks after ART in the overall group, the decrease in CRP was smaller in overweight/obese participants (p=0.01) and the decreases in both CRP (p=0.01) and IL-18 (p=0.02) were smaller in underweight participants. Each 1 unit gain in BMI among overweight/obese participants was associated with a 0.02 log10 increase in sCD14 (p=0.05), while each 1 unit BMI gain among underweight participants was associated with 9.32 mg/L decrease in CRP (p=0.001).
Conclusion
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.
J Infect Dis. 2016 Apr 1;213(7). doi: 10.1093/infdis/jiw096 First published online: March 8, 2016.