Inflammation and Change in Body Weight with Antiretroviral Therapy Initiation in a Multinational Cohort of HIV-Infected Adults

Vidya Mave, Kristine M. Erlandson, Nikhil Gupte, Ashwin Balagopal, David M. Asmuth, Thomas B. Campbell, Laura Smeaton, Nagalingeswaran Kumarasamy, James Hakim, Breno Santos, Cynthia Riviere, Mina C. Hosseinipour, Patcharaphan Sugandhavesa, Rosa Infante, Sandy Pillay, Sandra W. Cardoso, Srikanth Tripathy, Noluthando Mwelase, Sima Berendes, Bruno B. AndradeDavid L Thomas, Robert C Bollinger, Amita Gupta

Research output: Contribution to journalArticle

Abstract

Background. Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation during human immunodeficiency virus infection is unknown. Methods. Among a random virologically suppressed participants of the Prospective Evaluation of Antiretrovirals in Resource-Limited Settings trial, inflammatory markers were measured at weeks 0, 24, and 48 after antiretroviral therapy (ART) initiation. Associations between both baseline and change in body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) and changes in inflammation markers were assessed using random effects models. Results. Of 246 participants, 27% were overweight/obese (BMI, ≥ 25), and 8% were underweight (BMI <18.5) at baseline. After 48 weeks, 37% were overweight/obese, and 3% were underweight. While level of many inflammatory markers decreased 48 weeks after ART initiation in the overall group, the decrease in C-reactive protein (CRP) level was smaller in overweight/obese participants (P =. 01), and the decreases in both CRP (P =. 01) and interleukin 18 (P =. 02) levels were smaller in underweight participants. Each 1-unit gain in BMI among overweight/obese participants was associated with a 0.02-log10 increase in soluble CD14 level (P =. 05), while each 1-unit BMI gain among underweight participants was associated with a 9.32-mg/L decrease in CRP level (P =. 001). Conclusions. 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.

Original languageEnglish (US)
Pages (from-to)65-72
Number of pages8
JournalJournal of Infectious Diseases
Volume214
Issue number1
DOIs
StatePublished - Jul 1 2016

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Body Weight Changes
Thinness
HIV
Inflammation
C-Reactive Protein
Weight Gain
Therapeutics
Interleukin-18
Virus Diseases
Body Mass Index
Obesity
Weights and Measures

Keywords

  • body mass index
  • HAART clinical outcomes
  • HIV/AIDS
  • immune activation/inflammation
  • noncommunicable diseases

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

Cite this

Inflammation and Change in Body Weight with Antiretroviral Therapy Initiation in a Multinational Cohort of HIV-Infected Adults. / Mave, Vidya; Erlandson, Kristine M.; Gupte, Nikhil; Balagopal, Ashwin; Asmuth, David M.; Campbell, Thomas B.; Smeaton, Laura; Kumarasamy, Nagalingeswaran; Hakim, James; Santos, Breno; Riviere, Cynthia; Hosseinipour, Mina C.; Sugandhavesa, Patcharaphan; Infante, Rosa; Pillay, Sandy; Cardoso, Sandra W.; Tripathy, Srikanth; Mwelase, Noluthando; Berendes, Sima; Andrade, Bruno B.; Thomas, David L; Bollinger, Robert C; Gupta, Amita.

In: Journal of Infectious Diseases, Vol. 214, No. 1, 01.07.2016, p. 65-72.

Research output: Contribution to journalArticle

Mave, V, Erlandson, KM, Gupte, N, Balagopal, 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 2016, 'Inflammation and Change in Body Weight with Antiretroviral Therapy Initiation in a Multinational Cohort of HIV-Infected Adults', Journal of Infectious Diseases, vol. 214, no. 1, pp. 65-72. https://doi.org/10.1093/infdis/jiw096
Mave, Vidya ; Erlandson, Kristine M. ; Gupte, Nikhil ; Balagopal, Ashwin ; Asmuth, David M. ; Campbell, Thomas B. ; Smeaton, Laura ; Kumarasamy, Nagalingeswaran ; Hakim, James ; Santos, Breno ; Riviere, Cynthia ; Hosseinipour, Mina C. ; Sugandhavesa, Patcharaphan ; Infante, Rosa ; Pillay, Sandy ; Cardoso, Sandra W. ; Tripathy, Srikanth ; Mwelase, Noluthando ; Berendes, Sima ; Andrade, Bruno B. ; Thomas, David L ; Bollinger, Robert C ; Gupta, Amita. / Inflammation and Change in Body Weight with Antiretroviral Therapy Initiation in a Multinational Cohort of HIV-Infected Adults. In: Journal of Infectious Diseases. 2016 ; Vol. 214, No. 1. pp. 65-72.
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T1 - Inflammation and Change in Body Weight with Antiretroviral Therapy Initiation in a Multinational Cohort of HIV-Infected Adults

AU - Mave, Vidya

AU - Erlandson, Kristine M.

AU - Gupte, Nikhil

AU - Balagopal, Ashwin

AU - Asmuth, David M.

AU - Campbell, Thomas B.

AU - Smeaton, Laura

AU - Kumarasamy, Nagalingeswaran

AU - Hakim, James

AU - Santos, Breno

AU - Riviere, Cynthia

AU - Hosseinipour, Mina C.

AU - Sugandhavesa, Patcharaphan

AU - Infante, Rosa

AU - Pillay, Sandy

AU - Cardoso, Sandra W.

AU - Tripathy, Srikanth

AU - Mwelase, Noluthando

AU - Berendes, Sima

AU - Andrade, Bruno B.

AU - Thomas, David L

AU - Bollinger, Robert C

AU - Gupta, Amita

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background. Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation during human immunodeficiency virus infection is unknown. Methods. Among a random virologically suppressed participants of the Prospective Evaluation of Antiretrovirals in Resource-Limited Settings trial, inflammatory markers were measured at weeks 0, 24, and 48 after antiretroviral therapy (ART) initiation. Associations between both baseline and change in body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) and changes in inflammation markers were assessed using random effects models. Results. Of 246 participants, 27% were overweight/obese (BMI, ≥ 25), and 8% were underweight (BMI <18.5) at baseline. After 48 weeks, 37% were overweight/obese, and 3% were underweight. While level of many inflammatory markers decreased 48 weeks after ART initiation in the overall group, the decrease in C-reactive protein (CRP) level was smaller in overweight/obese participants (P =. 01), and the decreases in both CRP (P =. 01) and interleukin 18 (P =. 02) levels were smaller in underweight participants. Each 1-unit gain in BMI among overweight/obese participants was associated with a 0.02-log10 increase in soluble CD14 level (P =. 05), while each 1-unit BMI gain among underweight participants was associated with a 9.32-mg/L decrease in CRP level (P =. 001). Conclusions. 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.

AB - Background. Both wasting and obesity are associated with inflammation, but the extent to which body weight changes influence inflammation during human immunodeficiency virus infection is unknown. Methods. Among a random virologically suppressed participants of the Prospective Evaluation of Antiretrovirals in Resource-Limited Settings trial, inflammatory markers were measured at weeks 0, 24, and 48 after antiretroviral therapy (ART) initiation. Associations between both baseline and change in body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) and changes in inflammation markers were assessed using random effects models. Results. Of 246 participants, 27% were overweight/obese (BMI, ≥ 25), and 8% were underweight (BMI <18.5) at baseline. After 48 weeks, 37% were overweight/obese, and 3% were underweight. While level of many inflammatory markers decreased 48 weeks after ART initiation in the overall group, the decrease in C-reactive protein (CRP) level was smaller in overweight/obese participants (P =. 01), and the decreases in both CRP (P =. 01) and interleukin 18 (P =. 02) levels were smaller in underweight participants. Each 1-unit gain in BMI among overweight/obese participants was associated with a 0.02-log10 increase in soluble CD14 level (P =. 05), while each 1-unit BMI gain among underweight participants was associated with a 9.32-mg/L decrease in CRP level (P =. 001). Conclusions. 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.

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KW - HAART clinical outcomes

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KW - noncommunicable diseases

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