Overweight, obesity rates for patients with HIV similar to U.S. population

Wasting no longer a hallmark of HIV; researchers recommend obesity prevention measures for patients.

SAN DIEGO — A majority of people with HIV are overweight, mirroring trends in the rest of the U.S. population, according to the findings of a recent study.

Of more than 650 patients with HIV treated at two U.S. Navy clinics, 3% met the definition of wasting, whereas 63% were overweight or obese. The figure corresponds to a CDC estimate that 66% of Americans are either overweight or obese. Although some patients were overweight or obese at the time of diagnosis, 72% gained weight after HIV infection.

“As HIV has now become a chronic illness, patients with HIV are now dealing with issues of being obese rather than the wasting we had seen so commonly in the earlier stages of the epidemic,” said Nancy F. Crum-Cianflone, MD, an HIV research technician for the TriService AIDS Clinical Consortium. “Now we need to start focusing on regular health issues like cancer prevention, blood pressure control and excess weight gain.”

Crum-Cianflone and colleagues began the study after they noticed weight gain trends in their patients with HIV. She presented the study findings at the 45th Annual Meeting of the Infectious Diseases Society of America, held here recently.

Researchers found weight gain is more likely when HIV infection is being managed successfully and that younger age at diagnosis and duration of infection are predictors of weight gain.

The trend could be attributed to the lesser toxicity and greater efficacy of drugs now used to treat HIV/AIDS.

“Due to the improved treatments for HIV disease, patients are living longer, healthier lives and are not dying from life-threatening infections or wasting,” Crum-Cianflone said.

Military cohort used

Data from HIV patients (n=663) being treated at two military clinics were used in the study.

Mean patient age was 41 years. Fifty percent of the patients were white; 26% of patients were hypertensive and 8% were patients with diabetes.

Weight categories were defined by BMI. Wasting was defined as a BMI of less than 20, overweight was defined as a BMI of 25-29.9 and obesity was defined as a BMI of 30 or greater.

Majority overweight

Of patients, 63% (n=419) were overweight and 17% were obese. Only 3% of patients met the definition of wasting.

More patients were currently overweight or obese than at the time of their diagnosis: 63% vs. 49%. Over the course of HIV infection, 72% of patients gained weight at an average of 12.8 lb.

Elevated BMI was associated with younger age at HIV diagnosis, longer duration of HIV, high CD4 count and hypertension.

No relationship to specific antiretroviral regimens and weight gain were found. – by Kirsten H. Ellis

For more information:

• Crum-Cianflone NE, Tejidor R, Medina S, et al. Obesity among HIV patients: the latest epidemic. #888. Poster presented at: the 45th Annual Meeting of the Infectious Diseases Society of America; Oct. 4-7, 2007; San Diego.