Progressive increases in fat mass occur in adults living with HIV on antiretroviral therapy, but patterns differ by sex and anatomic depot

Paula Debroy, Myung Sim, Kristine M. Erlandson, Julian Falutz, Carla M. Prado, Todd T Brown, Giovanni Guaraldi, Jordan E. Lake

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Although weight gain on ART is common, the long-term trajectory of and factors affecting increases in fat mass in people living with HIV are not well described. METHODS: Men and women living with HIV in the Modena HIV Metabolic Clinic underwent DXA scans every 6-12 months for up to 10 years (median 4.6 years). Regression modelling in both combined and sex-stratified models determined changes in and clinical factors significantly associated with trunk and leg fat mass over the study period. RESULTS: A total of 839 women and 1759 men contributed two or more DXA scans. The baseline median age was 44 years and BMI 22.9 kg/m2; 76% were virologically suppressed on ART at baseline. For both sexes, trunk and leg fat consistently increased over the study period, with mean yearly trunk and leg fat gain of 3.6% and 7.5% in women and 6.3% and 10.8% in men, respectively. In multivariate analysis, factors associated with greater fat mass included female sex, per-year ART use (specifically tenofovir disoproxil fumarate and integrase strand transfer inhibitor therapy), per-unit BMI increase, no self-reported physical activity and CD4 nadir <200 cells/mm3. CONCLUSIONS: Among people living with HIV on ART, trunk and leg fat mass increased steadily over a median of 4.6 years of follow up, particularly among women. After controlling for traditional risk factors, HIV- and ART-specific risk factors emerged.

Original languageEnglish (US)
Pages (from-to)1028-1034
Number of pages7
JournalThe Journal of antimicrobial chemotherapy
Volume74
Issue number4
DOIs
StatePublished - Apr 1 2019

Fingerprint

Fats
HIV
Leg
Tenofovir
Photon Absorptiometry
Therapeutics
Integrases
Weight Gain
Multivariate Analysis
Exercise

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Progressive increases in fat mass occur in adults living with HIV on antiretroviral therapy, but patterns differ by sex and anatomic depot. / Debroy, Paula; Sim, Myung; Erlandson, Kristine M.; Falutz, Julian; Prado, Carla M.; Brown, Todd T; Guaraldi, Giovanni; Lake, Jordan E.

In: The Journal of antimicrobial chemotherapy, Vol. 74, No. 4, 01.04.2019, p. 1028-1034.

Research output: Contribution to journalArticle

Debroy, Paula ; Sim, Myung ; Erlandson, Kristine M. ; Falutz, Julian ; Prado, Carla M. ; Brown, Todd T ; Guaraldi, Giovanni ; Lake, Jordan E. / Progressive increases in fat mass occur in adults living with HIV on antiretroviral therapy, but patterns differ by sex and anatomic depot. In: The Journal of antimicrobial chemotherapy. 2019 ; Vol. 74, No. 4. pp. 1028-1034.
@article{c6c94c4fad1147b0a0cbcccbdfdad106,
title = "Progressive increases in fat mass occur in adults living with HIV on antiretroviral therapy, but patterns differ by sex and anatomic depot",
abstract = "OBJECTIVES: Although weight gain on ART is common, the long-term trajectory of and factors affecting increases in fat mass in people living with HIV are not well described. METHODS: Men and women living with HIV in the Modena HIV Metabolic Clinic underwent DXA scans every 6-12 months for up to 10 years (median 4.6 years). Regression modelling in both combined and sex-stratified models determined changes in and clinical factors significantly associated with trunk and leg fat mass over the study period. RESULTS: A total of 839 women and 1759 men contributed two or more DXA scans. The baseline median age was 44 years and BMI 22.9 kg/m2; 76{\%} were virologically suppressed on ART at baseline. For both sexes, trunk and leg fat consistently increased over the study period, with mean yearly trunk and leg fat gain of 3.6{\%} and 7.5{\%} in women and 6.3{\%} and 10.8{\%} in men, respectively. In multivariate analysis, factors associated with greater fat mass included female sex, per-year ART use (specifically tenofovir disoproxil fumarate and integrase strand transfer inhibitor therapy), per-unit BMI increase, no self-reported physical activity and CD4 nadir <200 cells/mm3. CONCLUSIONS: Among people living with HIV on ART, trunk and leg fat mass increased steadily over a median of 4.6 years of follow up, particularly among women. After controlling for traditional risk factors, HIV- and ART-specific risk factors emerged.",
author = "Paula Debroy and Myung Sim and Erlandson, {Kristine M.} and Julian Falutz and Prado, {Carla M.} and Brown, {Todd T} and Giovanni Guaraldi and Lake, {Jordan E.}",
year = "2019",
month = "4",
day = "1",
doi = "10.1093/jac/dky551",
language = "English (US)",
volume = "74",
pages = "1028--1034",
journal = "Journal of Antimicrobial Chemotherapy",
issn = "0305-7453",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Progressive increases in fat mass occur in adults living with HIV on antiretroviral therapy, but patterns differ by sex and anatomic depot

AU - Debroy, Paula

AU - Sim, Myung

AU - Erlandson, Kristine M.

AU - Falutz, Julian

AU - Prado, Carla M.

AU - Brown, Todd T

AU - Guaraldi, Giovanni

AU - Lake, Jordan E.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - OBJECTIVES: Although weight gain on ART is common, the long-term trajectory of and factors affecting increases in fat mass in people living with HIV are not well described. METHODS: Men and women living with HIV in the Modena HIV Metabolic Clinic underwent DXA scans every 6-12 months for up to 10 years (median 4.6 years). Regression modelling in both combined and sex-stratified models determined changes in and clinical factors significantly associated with trunk and leg fat mass over the study period. RESULTS: A total of 839 women and 1759 men contributed two or more DXA scans. The baseline median age was 44 years and BMI 22.9 kg/m2; 76% were virologically suppressed on ART at baseline. For both sexes, trunk and leg fat consistently increased over the study period, with mean yearly trunk and leg fat gain of 3.6% and 7.5% in women and 6.3% and 10.8% in men, respectively. In multivariate analysis, factors associated with greater fat mass included female sex, per-year ART use (specifically tenofovir disoproxil fumarate and integrase strand transfer inhibitor therapy), per-unit BMI increase, no self-reported physical activity and CD4 nadir <200 cells/mm3. CONCLUSIONS: Among people living with HIV on ART, trunk and leg fat mass increased steadily over a median of 4.6 years of follow up, particularly among women. After controlling for traditional risk factors, HIV- and ART-specific risk factors emerged.

AB - OBJECTIVES: Although weight gain on ART is common, the long-term trajectory of and factors affecting increases in fat mass in people living with HIV are not well described. METHODS: Men and women living with HIV in the Modena HIV Metabolic Clinic underwent DXA scans every 6-12 months for up to 10 years (median 4.6 years). Regression modelling in both combined and sex-stratified models determined changes in and clinical factors significantly associated with trunk and leg fat mass over the study period. RESULTS: A total of 839 women and 1759 men contributed two or more DXA scans. The baseline median age was 44 years and BMI 22.9 kg/m2; 76% were virologically suppressed on ART at baseline. For both sexes, trunk and leg fat consistently increased over the study period, with mean yearly trunk and leg fat gain of 3.6% and 7.5% in women and 6.3% and 10.8% in men, respectively. In multivariate analysis, factors associated with greater fat mass included female sex, per-year ART use (specifically tenofovir disoproxil fumarate and integrase strand transfer inhibitor therapy), per-unit BMI increase, no self-reported physical activity and CD4 nadir <200 cells/mm3. CONCLUSIONS: Among people living with HIV on ART, trunk and leg fat mass increased steadily over a median of 4.6 years of follow up, particularly among women. After controlling for traditional risk factors, HIV- and ART-specific risk factors emerged.

UR - http://www.scopus.com/inward/record.url?scp=85062961085&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062961085&partnerID=8YFLogxK

U2 - 10.1093/jac/dky551

DO - 10.1093/jac/dky551

M3 - Article

C2 - 30668716

AN - SCOPUS:85062961085

VL - 74

SP - 1028

EP - 1034

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 4

ER -