Table 3.
Factors associated with the development of obesity in HIV-infected individuals on ART
| Remained non-obese (BMI <30 kg/m2), n = 1281 (81.7%) | Developed obesity (BMI ≥30 kg/m2), n = 286 (18.3%) | Total, n = 1567 | Crude HR (95% CI) | |
|---|---|---|---|---|
| Follow-up time (years), median (IQR) | 4.7 (2.5–7.4) | 1.9 (0.9–3.6) | 4.1 (2.1–7.0) | |
| Age (years) at ART initiation | ||||
| median (IQR) | 35.7 (29.0–43.8) | 36.5 (30.9–43.5) | 36.0 (29.3–43.8) | 1.02c (0.91–1.15) |
| <30 | 365 (28.5%) | 64 (22.4%) | 429 (27.4%) | |
| 30–39 | 450 (35.1%) | 114 (39.9%) | 564 (36.0%) | |
| 40–49 | 325 (25.4%) | 75 (26.2%) | 400 (25.5%) | |
| ≥50 | 141 (11.0%) | 33 (11.5%) | 174 (11.1%) | |
| Sex | ||||
| male | 815 (63.6%) | 163 (57.0%) | 978 (62.4%) | reference |
| female | 307 (24.0%) | 99 (34.6%) | 406 (25.9%) | 1.48 (1.15–1.90) |
| TW | 159 (12.4%) | 24 (8.4%) | 183 (11.7%) | 0.80 (0.52–1.23) |
| Race/skin colour | ||||
| white | 633 (49.4%) | 140 (49.0%) | 773 (49.3%) | reference |
| black | 241 (18.8%) | 57 (19.9%) | 298 (19.0%) | 1.27 (0.93–1.73) |
| mixed/other | 407 (31.8%) | 89 (31.1%) | 496 (31.7%) | 1.12 (0.86–1.46) |
| Education level | ||||
| 0–8 years | 626 (48.9%) | 155 (54.2%) | 781 (49.8%) | reference |
| >8 years | 655 (51.1%) | 131 (45.8%) | 786 (50.2%) | 0.94 (0.74–1.18) |
| Baseline BMI (kg/m2) | ||||
| median (IQR)a | 21.8 (19.4–24.0) | 25.3 (22.3–27.7) | 22.3 (19.9–24.9) | 1.15 (1.04–1.28) |
| underweight (<18.5) | 217 (16.9%) | 6 (2.1%) | 223 (14.2%) | |
| normal weight (18.5–24.9) | 839 (65.5%) | 130 (45.5%) | 969 (61.8%) | |
| overweight (25–29.9) | 225 (17.6%) | 150 (52.4%) | 375 (23.9%) | |
| Baseline CD4+ T lymphocyte count (cells/mm³) | ||||
| median (IQR)a,b | 233 (90–355) | 152 (48–287) | 222 (78–343) | 0.74d (0.61–0.90) |
| <100 | 319 (24.9%) | 102 (35.7%) | 421 (26.9%) | |
| 100–249 | 331 (25.8%) | 72 (25.2%) | 403 (25.7%) | |
| 250–500 | 428 (33.4%) | 68 (23.8%) | 496 (31.7%) | |
| >500 | 122 (9.5%) | 16 (5.6%) | 138 (8.8%) | |
| missing | 81 (6.3%) | 28 (9.8%) | 109 (7.0%) | |
| Baseline viral load (copies/mL) | ||||
| median log10 (IQR)b | 4.8 (4.0–5.4) | 5.0 (4.2–5.5) | 4.8 (4.1–5.4) | 1.09 (0.96–1.23) |
| <100 000 | 681 (53.2%) | 119 (41.6%) | 800 (51.1%) | |
| ≥100 000 | 452 (35.3%) | 115 (40.2%) | 567 (36.2%) | |
| missing | 148 (11.6%) | 52 (18.2%) | 200 (12.8%) | |
| Years from HIV diagnosis to ART start, median (IQR) | 0.6 (0.2–2.5) | 0.5 (0.2–2.3) | 0.6 (0.2–2.5) | 0.98 (0.94–1.02) |
| Most-used NRTI | ||||
| TDF | 767 (59.9%) | 147 (51.4%) | 914 (58.3%) | reference |
| AZT | 514 (40.1%) | 139 (48.6%) | 653 (41.7%) | 0.86 (0.68–1.09) |
| Most-used ART core drug class | ||||
| NNRTI | 858 (67.0%) | 180 (62.9%) | 1038 (66.2%) | reference |
| PI | 415 (32.4%) | 100 (35.0%) | 515 (32.9%) | 1.04 (0.82–1.33) |
| INSTI | 8 (0.6%) | 6 (2.1%) | 14 (0.9%) | 8.57 (3.77–19.47) |
| History of hypertension | 121 (9.4%) | 52 (18.2%) | 173 (11.0%) | 1.92 (1.42–2.60) |
| History of diabetes | 47 (3.7%) | 16 (5.6%) | 63 (4.0%) | 1.74 (1.05–2.88) |
| History of dyslipidaemia | 329 (25.7%) | 70 (24.5%) | 399 (25.5%) | 1.03 (0.78–1.34) |
| History of an AIDS-defining illness | 489 (38.2%) | 125 (43.7%) | 614 (39.2%) | 1.11 (0.88–1.40) |
| Ever smoker | 676 (52.8%) | 145 (50.7%) | 821 (52.4%) | 0.84 (0.66–1.06) |
Data are n (%) unless otherwise stated.
TDF, tenofovir; AZT, zidovudine.
a
Variable included in model using restricted cubic spline.
b
Missing values imputed in the models.
c
Crude HR per 10 year increase in age.
d
Crude HR per 100 cell increase in CD4+ T lymphocyte count.