Body mass index and risk of tuberculosis and death

Colleen Hanrahan, Jonathan E Golub, Lerato Mohapi, Nkeko Tshabangu, Tebogo Modisenyane, Richard E Chaisson, Glenda E. Gray, James A. McIntyre, Neil A. Martinson

Research output: Contribution to journalArticle

Abstract

Background: High BMI has been shown to be protective against tuberculosis (TB) among HIV-uninfected individuals, as well as against disease progression and mortality among those with HIV. We examined the effect of BMI on all-cause mortality and TB incidence among a cohort of HIV-infected adults in Soweto, South Africa. Methods: A clinical cohort of 3456 HIV-infected adults from South Africa was prospectively followed from 2003 to 2008 with regular monitoring. The primary exposure was BMI and the outcomes of interest were all-cause mortality and a newly diagnosed episode of TB. Cox proportional hazard models assessed associations with risk of mortality or incident TB. Results: Incidence rates of mortality were 10.4/100 person-years for baseline BMI of 18.5 or less, 3.6/100 person-years for baseline BMI 18.6-25, 1.7/100 person-years for baseline BMI 25.1-30, and 1.6/100 person-years for baseline BMI more than 30. Compared to those with normal BMI, overweight and obese participants had a significantly reduced risk of mortality [adjusted hazard ratio 0.59 (95% confidence interval, CI 0.40-0.87) and 0.48 (95% CI 0.29-0.80), respectively]. Incidence rates of TB by baseline BMI were 7.3/100 person-years for underweight, 6.0/100 person-years for normal, 3.2/100 person-years for overweight, and 1.9/100 person-years for obese. Compared to those with normal BMI, those with overweight and obese BMI were at a significantly reduced risk of developing TB [adjusted hazard ratio 0.56 (95% CI 0.38-0.83) and 0.33 (95% CI 0.19-0.55), respectively]. Conclusion: HIV-infected individuals with obese and overweight BMI have a significantly reduced risk of both mortality and TB, after adjusting for HAART use and CD4 cell count.

Original languageEnglish (US)
Pages (from-to)1501-1508
Number of pages8
JournalAIDS
Volume24
Issue number10
DOIs
StatePublished - Jun 19 2010

Fingerprint

Tuberculosis
Body Mass Index
Mortality
HIV
South Africa
Incidence
Thinness
Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
Proportional Hazards Models
Disease Progression
Confidence Intervals

Keywords

  • body mass index
  • HAART
  • HIV
  • mortality
  • nutrition
  • tuberculosis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Hanrahan, C., Golub, J. E., Mohapi, L., Tshabangu, N., Modisenyane, T., Chaisson, R. E., ... Martinson, N. A. (2010). Body mass index and risk of tuberculosis and death. AIDS, 24(10), 1501-1508. https://doi.org/10.1097/QAD.0b013e32833a2a4a

Body mass index and risk of tuberculosis and death. / Hanrahan, Colleen; Golub, Jonathan E; Mohapi, Lerato; Tshabangu, Nkeko; Modisenyane, Tebogo; Chaisson, Richard E; Gray, Glenda E.; McIntyre, James A.; Martinson, Neil A.

In: AIDS, Vol. 24, No. 10, 19.06.2010, p. 1501-1508.

Research output: Contribution to journalArticle

Hanrahan, C, Golub, JE, Mohapi, L, Tshabangu, N, Modisenyane, T, Chaisson, RE, Gray, GE, McIntyre, JA & Martinson, NA 2010, 'Body mass index and risk of tuberculosis and death', AIDS, vol. 24, no. 10, pp. 1501-1508. https://doi.org/10.1097/QAD.0b013e32833a2a4a
Hanrahan, Colleen ; Golub, Jonathan E ; Mohapi, Lerato ; Tshabangu, Nkeko ; Modisenyane, Tebogo ; Chaisson, Richard E ; Gray, Glenda E. ; McIntyre, James A. ; Martinson, Neil A. / Body mass index and risk of tuberculosis and death. In: AIDS. 2010 ; Vol. 24, No. 10. pp. 1501-1508.
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AU - Mohapi, Lerato

AU - Tshabangu, Nkeko

AU - Modisenyane, Tebogo

AU - Chaisson, Richard E

AU - Gray, Glenda E.

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N2 - Background: High BMI has been shown to be protective against tuberculosis (TB) among HIV-uninfected individuals, as well as against disease progression and mortality among those with HIV. We examined the effect of BMI on all-cause mortality and TB incidence among a cohort of HIV-infected adults in Soweto, South Africa. Methods: A clinical cohort of 3456 HIV-infected adults from South Africa was prospectively followed from 2003 to 2008 with regular monitoring. The primary exposure was BMI and the outcomes of interest were all-cause mortality and a newly diagnosed episode of TB. Cox proportional hazard models assessed associations with risk of mortality or incident TB. Results: Incidence rates of mortality were 10.4/100 person-years for baseline BMI of 18.5 or less, 3.6/100 person-years for baseline BMI 18.6-25, 1.7/100 person-years for baseline BMI 25.1-30, and 1.6/100 person-years for baseline BMI more than 30. Compared to those with normal BMI, overweight and obese participants had a significantly reduced risk of mortality [adjusted hazard ratio 0.59 (95% confidence interval, CI 0.40-0.87) and 0.48 (95% CI 0.29-0.80), respectively]. Incidence rates of TB by baseline BMI were 7.3/100 person-years for underweight, 6.0/100 person-years for normal, 3.2/100 person-years for overweight, and 1.9/100 person-years for obese. Compared to those with normal BMI, those with overweight and obese BMI were at a significantly reduced risk of developing TB [adjusted hazard ratio 0.56 (95% CI 0.38-0.83) and 0.33 (95% CI 0.19-0.55), respectively]. Conclusion: HIV-infected individuals with obese and overweight BMI have a significantly reduced risk of both mortality and TB, after adjusting for HAART use and CD4 cell count.

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