Diana Huisin ʼt Veld1, Eric Balestre, Jozefien Buyze, Joris Menten, Antoine Jaquet, David A Cooper, Francois Dabis, Constantin T Yiannoutsos, Lameck Diero, Portia Mutevedzi, Matthew P Fox, Eugene Messou, Christopher J Hoffmann, Hans W Prozesky, Matthias Egger, Jennifer J Hemingway-Foday, Robert Colebunders. 1. *Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium; †Clinical Sciences Department, Institute of Tropical Medicine, Antwerp, Belgium; ‡Department of Epidemiology and Biostatistics Fonds Wetenschappelijk Onderzoek-Vlaanderen, Aspirant Mandate Holder, FWO, Brussels, Belgium; §Université Bordeaux, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, Bordeaux, France; ‖ISPED, Centre INSERM U 897-Epidemiologie-Biostatistique, University of Bordeaux, Bordeaux, France; ¶Kirby Institute University of New South Wales and Centre for Applied Medical Research, St Vincent's Hospital, Sydney, Australia; #Department of Biostatistics, Indiana University School of Public Health, Indianapolis, IN; **Department of Medicine, Moi University/Ampath, Eldoret, Kenya; ††Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa; ‡‡Department of Infection and Population Health, University College London, London, United Kingdom; §§Centre for Global Health & Development, Boston University, Boston, MA; ‖‖Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; ¶¶Centre de prise en charge de recherche et de formation (CePReF), Hôpital Yopougon Attié, Abidjan, Côte d'Ivoire; ##The Aurum Institute, Johannesburg, South Africa; ***Centre for AIDS Research, John Hopkins University, Baltimore, MD; †††Division of Infectious Diseases, Department of Medicine, University of Stellenbosch and Tygerberg Academic Hospital, Cape Town, South Africa; ‡‡‡Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; §§§Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; and ‖‖‖RTI International, Research Triangle Pa
Abstract
BACKGROUND: In resource-limited settings, clinical parameters, including body weight changes, are used to monitor clinical response. Therefore, we studied body weight changes in patients on antiretroviral treatment (ART) in different regions of the world. METHODS: Data were extracted from the "International Epidemiologic Databases to Evaluate AIDS," a network of ART programmes that prospectively collects routine clinical data. Adults on ART from the Southern, East, West, and Central African and the Asia-Pacific regions were selected from the database if baseline data on body weight, gender, ART regimen, and CD4 count were available. Body weight change over the first 2 years and the probability of body weight loss in the second year were modeled using linear mixed models and logistic regression, respectively. RESULTS: Data from 205,571 patients were analyzed. Mean adjusted body weight change in the first 12 months was higher in patients started on tenofovir and/or efavirenz; in patients from Central, West, and East Africa, in men, and in patients with a poorer clinical status. In the second year of ART, it was greater in patients initiated on tenofovir and/or nevirapine, and for patients not on stavudine, in women, in Southern Africa and in patients with a better clinical status at initiation. Stavudine in the initial regimen was associated with a lower mean adjusted body weight change and with weight loss in the second treatment year. CONCLUSIONS: Different ART regimens have different effects on body weight change. Body weight loss after 1 year of treatment in patients on stavudine might be associated with lipoatrophy.
BACKGROUND: In resource-limited settings, clinical parameters, including body weight changes, are used to monitor clinical response. Therefore, we studied body weight changes in patients on antiretroviral treatment (ART) in different regions of the world. METHODS: Data were extracted from the "International Epidemiologic Databases to Evaluate AIDS," a network of ART programmes that prospectively collects routine clinical data. Adults on ART from the Southern, East, West, and Central African and the Asia-Pacific regions were selected from the database if baseline data on body weight, gender, ART regimen, and CD4 count were available. Body weight change over the first 2 years and the probability of body weight loss in the second year were modeled using linear mixed models and logistic regression, respectively. RESULTS: Data from 205,571 patients were analyzed. Mean adjusted body weight change in the first 12 months was higher in patients started on tenofovir and/or efavirenz; in patients from Central, West, and East Africa, in men, and in patients with a poorer clinical status. In the second year of ART, it was greater in patients initiated on tenofovir and/or nevirapine, and for patients not on stavudine, in women, in Southern Africa and in patients with a better clinical status at initiation. Stavudine in the initial regimen was associated with a lower mean adjusted body weight change and with weight loss in the second treatment year. CONCLUSIONS: Different ART regimens have different effects on body weight change. Body weight loss after 1 year of treatment in patients on stavudine might be associated with lipoatrophy.
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