The effect of HIV and the modifying effect of anti-retroviral therapy (ART) on body mass index (BMI) and blood pressure levels in rural South Africa

Background High BMI and blood pressure are leading chronic disease risk factors in South Africa. Longterm effects of HIV and ART on adiposity and blood pressure are poorly understood, and direct comparisons of risk factor trajectories in HIV- versus HIV+ populations are rare. Methods In 2003 and 201...

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Hauptverfasser: Feigl, Andrea B. (VerfasserIn) , Bloom, David E. (VerfasserIn) , Danaei, Goodarz (VerfasserIn) , Pillay, Deenan (VerfasserIn) , Salomon, Joshua A. (VerfasserIn) , Tanser, Frank (VerfasserIn) , Bärnighausen, Till (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: August 23, 2016
In: PLOS ONE
Year: 2016, Jahrgang: 11, Heft: 8
ISSN:1932-6203
DOI:10.1371/journal.pone.0158264
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1371/journal.pone.0158264
Verlag, lizenzpflichtig, Volltext: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158264
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Verfasserangaben:Andrea B. Feigl, David E. Bloom, Goodarz Danaei, Deenan Pillay, Joshua A. Salomon, Frank Tanser, Till W. Bärnighausen

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520 |a Background High BMI and blood pressure are leading chronic disease risk factors in South Africa. Longterm effects of HIV and ART on adiposity and blood pressure are poorly understood, and direct comparisons of risk factor trajectories in HIV- versus HIV+ populations are rare. Methods In 2003 and 2010, height, weight, and blood pressure were recorded in a study population (n = 505) in KwaZulu-Natal, South Africa (30% adult HIV prevalence). We modeled change in BMI and BP longitudinally in HIV- individuals (n = 315), seroconverters (n = 32), HIV+ patients not on ART (HIV+ART−; n = 52), HIV+ patients on ART for 0-<2 years as of 2010 (HIV+ART0-<2 yrs; n = 18), patients on ART for 2-5 years (HIV+ART2-5yrs; n = 44), and a subgroup with unknown HIV status (n = 44). Difference-in-differences were assessed in reference to the HIV- population. Results Between 2003 and 2010, BMI increased significantly in the HIV- group, by 0.874 (95% CI 0.339, 1.41; p = 0.001), to 30.4. BMI drop was significantly greater in HIV+ART0-<2yrs than in HIV+ART2-5yrs (p = 0.005). DID in BMI in HIV+ART0-<2yrs versus the reference was -5.21 (95% CI -7.53, -2.90; p = 0.001), and DID in HIV+ART2-5yrs versus reference was -1.35 (95% CI -2.89, 0.189; p = 0.086). DID in SBP in HIV+ART−vs HIV- DID was -7.55 mmHg (95% CI -13.2 to -1.90; p = 0.009). Conclusion Short-term ART (0-<2 years) was associated with larger weight loss than either no ART or long-term ART. Once on ART for 2+ years, individuals ‘caught up’ on weight gain with the HIV- population. Our results showcase the importance of health system readiness to address the burgeoning double burden of disease in South Africa. 
650 4 |a Antiretroviral therapy 
650 4 |a Antiretrovirals 
650 4 |a Blood pressure 
650 4 |a Body mass index 
650 4 |a HIV 
650 4 |a South Africa 
650 4 |a Surveys 
650 4 |a Weight gain 
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