Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV

Objectives: We investigated weight changes following antiretroviral therapy (ART) initiation, the development of metabolic syndrome (MetS) and its association with all-cause mortality among Asian adults living with HIV. Methods: Participants enrolled in a regional Asian HIV-infected cohort with weig...

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Main Authors: Win Min Han, Matthew G. Law, Jun Yong Choi, Rossana Ditangco, Nagalingeswaran Kumarasamy, Romanee Chaiwarith, Penh Sun Ly, Suwimon Khusuwan, Tuti Parwati Merati, Cuong Duy Do, Evy Yunihastuti, Iskandar Azwa, Man Po Lee, Thach Ngoc Pham, Yu Jiun Chan, Sasisopin Kiertiburanakul, Oon Tek Ng, Junko Tanuma, Sanjay Pujari, Fujie Zhang, Yasmin Gani, Vidya Mave, Jeremy Ross, Anchalee Avihingsanon, P. S. Ly, V. Khol, F. J. Zhang, H. X. Zhao, N. Han, M. P. Lee, P. C.K. Li, T. S. Kwong, T. H. Li, N. Kumarasamy, C. Ezhilarasi, S. Pujari, K. Joshi, S. Gaikwad, A. Chitalikar, S. Sangle, V. Mave, I. Marbaniang, S. Nimkar, D. N. Wirawan, F. Yuliana, A. Widhani, S. Maria, T. H. Karjadi, J. Tanuma, S. Oka, T. Nishijima, J. Y. Choi, S. Na, J. M. Kim, N. B. Rudi, A. Kamarulzaman, S. F. SyedOmar, S. Ponnampalavanar, M. K. Pasayan, M. L. Mationg, W. W. Ku, P. C. Wu, E. Ke, O. T. Ng, P. L. Lim, L. S. Lee, T. Yap, A. Avihingsanon, S. Gatechompol, P. Phanuphak, C. Phadungphon, S. Kiertiburanakul, A. Phuphuakrat, L. Chumla, N. Sanmeema, R. Chaiwarith, T. Sirisanthana, J. Praparattanapan, K. Nuket, P. Payoong, P. Kantipong, P. Kambua, T. N. Pham, K. V. Nguyen, D. T.H. Nguyen, D. T. Nguyen, C. D. Do, A. V. Ngo, L. T. Nguyen, A. H. Sohn, J. L. Ross, B. Petersen
Other Authors: Hospital Sungai Buloh
Format: Article
Published: 2022
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/74780
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Institution: Mahidol University
id th-mahidol.74780
record_format dspace
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Win Min Han
Matthew G. Law
Jun Yong Choi
Rossana Ditangco
Nagalingeswaran Kumarasamy
Romanee Chaiwarith
Penh Sun Ly
Suwimon Khusuwan
Tuti Parwati Merati
Cuong Duy Do
Evy Yunihastuti
Iskandar Azwa
Man Po Lee
Thach Ngoc Pham
Yu Jiun Chan
Sasisopin Kiertiburanakul
Oon Tek Ng
Junko Tanuma
Sanjay Pujari
Fujie Zhang
Yasmin Gani
Vidya Mave
Jeremy Ross
Anchalee Avihingsanon
P. S. Ly
V. Khol
F. J. Zhang
H. X. Zhao
N. Han
M. P. Lee
P. C.K. Li
T. S. Kwong
T. H. Li
N. Kumarasamy
C. Ezhilarasi
S. Pujari
K. Joshi
S. Gaikwad
A. Chitalikar
S. Sangle
V. Mave
I. Marbaniang
S. Nimkar
D. N. Wirawan
F. Yuliana
A. Widhani
S. Maria
T. H. Karjadi
J. Tanuma
S. Oka
T. Nishijima
J. Y. Choi
S. Na
J. M. Kim
N. B. Rudi
A. Kamarulzaman
S. F. SyedOmar
S. Ponnampalavanar
M. K. Pasayan
M. L. Mationg
W. W. Ku
P. C. Wu
E. Ke
O. T. Ng
P. L. Lim
L. S. Lee
T. Yap
O. T. Ng
A. Avihingsanon
S. Gatechompol
P. Phanuphak
C. Phadungphon
S. Kiertiburanakul
A. Phuphuakrat
L. Chumla
N. Sanmeema
R. Chaiwarith
T. Sirisanthana
J. Praparattanapan
K. Nuket
P. Payoong
P. Kantipong
P. Kambua
T. N. Pham
K. V. Nguyen
D. T.H. Nguyen
D. T. Nguyen
C. D. Do
A. V. Ngo
L. T. Nguyen
A. H. Sohn
J. L. Ross
B. Petersen
Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV
description Objectives: We investigated weight changes following antiretroviral therapy (ART) initiation, the development of metabolic syndrome (MetS) and its association with all-cause mortality among Asian adults living with HIV. Methods: Participants enrolled in a regional Asian HIV-infected cohort with weight and height measurements at ART initiation were eligible for inclusion in the analysis. Factors associated with weight changes and incident MetS (according to the International Diabetic Federation (IDF) definition) were analysed using linear mixed models and Cox regression, respectively. Competing-risk regression models were used to investigate the association of MetS with all-cause mortality. Results: Among 4931 people living with HIV (PLWH), 66% were male. At ART initiation, the median age was 34 [interquartile range (IQR) 29–41] years, and the median (IQR) weight and body mass index (BMI) were 55 (48–63) kg and 20.5 (18.4–22.9) kg/m2, respectively. At 1, 2 and 3 years of ART, overall mean (± standard deviation) weight gain was 2.2 (±5.3), 3.0 (±6.2) and 3.7 (±6.5) kg, respectively. Participants with baseline CD4 count ≤ 200 cells/µL [weight difference (diff) = 2.2 kg; 95% confidence interval (CI) 1.9–2.5 kg] and baseline HIV RNA ≥ 100 000 HIV-1 RNA copies/mL (diff = 0.6 kg; 95% CI 0.2–1.0 kg), and those starting with integrase strand transfer inhibitor (INSTI)-based ART (diff = 2.1 kg; 95% CI 0.7–3.5 kg vs. nonnucleoside reverse transcriptase inhibitors) had greater weight gain. After exclusion of those with abnormal baseline levels of MetS components, 295/3503 had incident MetS [1.18 (95% CI 1.05–1.32)/100 person-years (PY)]. The mortality rate was 0.7 (95% CI 0.6–0.8)/100 PY. MetS was not significantly associated with all-cause mortality in the adjusted model (P = 0.236). Conclusions: Weight gain after ART initiation was significantly higher among those initiating ART with lower CD4 count, higher HIV RNA and an INSTI-based regimen after controlling for baseline BMI. Greater efforts to identify and manage MetS among PLWH are needed.
author2 Hospital Sungai Buloh
author_facet Hospital Sungai Buloh
Win Min Han
Matthew G. Law
Jun Yong Choi
Rossana Ditangco
Nagalingeswaran Kumarasamy
Romanee Chaiwarith
Penh Sun Ly
Suwimon Khusuwan
Tuti Parwati Merati
Cuong Duy Do
Evy Yunihastuti
Iskandar Azwa
Man Po Lee
Thach Ngoc Pham
Yu Jiun Chan
Sasisopin Kiertiburanakul
Oon Tek Ng
Junko Tanuma
Sanjay Pujari
Fujie Zhang
Yasmin Gani
Vidya Mave
Jeremy Ross
Anchalee Avihingsanon
P. S. Ly
V. Khol
F. J. Zhang
H. X. Zhao
N. Han
M. P. Lee
P. C.K. Li
T. S. Kwong
T. H. Li
N. Kumarasamy
C. Ezhilarasi
S. Pujari
K. Joshi
S. Gaikwad
A. Chitalikar
S. Sangle
V. Mave
I. Marbaniang
S. Nimkar
D. N. Wirawan
F. Yuliana
A. Widhani
S. Maria
T. H. Karjadi
J. Tanuma
S. Oka
T. Nishijima
J. Y. Choi
S. Na
J. M. Kim
N. B. Rudi
A. Kamarulzaman
S. F. SyedOmar
S. Ponnampalavanar
M. K. Pasayan
M. L. Mationg
W. W. Ku
P. C. Wu
E. Ke
O. T. Ng
P. L. Lim
L. S. Lee
T. Yap
O. T. Ng
A. Avihingsanon
S. Gatechompol
P. Phanuphak
C. Phadungphon
S. Kiertiburanakul
A. Phuphuakrat
L. Chumla
N. Sanmeema
R. Chaiwarith
T. Sirisanthana
J. Praparattanapan
K. Nuket
P. Payoong
P. Kantipong
P. Kambua
T. N. Pham
K. V. Nguyen
D. T.H. Nguyen
D. T. Nguyen
C. D. Do
A. V. Ngo
L. T. Nguyen
A. H. Sohn
J. L. Ross
B. Petersen
format Article
author Win Min Han
Matthew G. Law
Jun Yong Choi
Rossana Ditangco
Nagalingeswaran Kumarasamy
Romanee Chaiwarith
Penh Sun Ly
Suwimon Khusuwan
Tuti Parwati Merati
Cuong Duy Do
Evy Yunihastuti
Iskandar Azwa
Man Po Lee
Thach Ngoc Pham
Yu Jiun Chan
Sasisopin Kiertiburanakul
Oon Tek Ng
Junko Tanuma
Sanjay Pujari
Fujie Zhang
Yasmin Gani
Vidya Mave
Jeremy Ross
Anchalee Avihingsanon
P. S. Ly
V. Khol
F. J. Zhang
H. X. Zhao
N. Han
M. P. Lee
P. C.K. Li
T. S. Kwong
T. H. Li
N. Kumarasamy
C. Ezhilarasi
S. Pujari
K. Joshi
S. Gaikwad
A. Chitalikar
S. Sangle
V. Mave
I. Marbaniang
S. Nimkar
D. N. Wirawan
F. Yuliana
A. Widhani
S. Maria
T. H. Karjadi
J. Tanuma
S. Oka
T. Nishijima
J. Y. Choi
S. Na
J. M. Kim
N. B. Rudi
A. Kamarulzaman
S. F. SyedOmar
S. Ponnampalavanar
M. K. Pasayan
M. L. Mationg
W. W. Ku
P. C. Wu
E. Ke
O. T. Ng
P. L. Lim
L. S. Lee
T. Yap
O. T. Ng
A. Avihingsanon
S. Gatechompol
P. Phanuphak
C. Phadungphon
S. Kiertiburanakul
A. Phuphuakrat
L. Chumla
N. Sanmeema
R. Chaiwarith
T. Sirisanthana
J. Praparattanapan
K. Nuket
P. Payoong
P. Kantipong
P. Kambua
T. N. Pham
K. V. Nguyen
D. T.H. Nguyen
D. T. Nguyen
C. D. Do
A. V. Ngo
L. T. Nguyen
A. H. Sohn
J. L. Ross
B. Petersen
author_sort Win Min Han
title Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV
title_short Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV
title_full Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV
title_fullStr Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV
title_full_unstemmed Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV
title_sort weight changes, metabolic syndrome and all-cause mortality among asian adults living with hiv
publishDate 2022
url https://repository.li.mahidol.ac.th/handle/123456789/74780
_version_ 1763493970817581056
spelling th-mahidol.747802022-08-04T11:29:24Z Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV Win Min Han Matthew G. Law Jun Yong Choi Rossana Ditangco Nagalingeswaran Kumarasamy Romanee Chaiwarith Penh Sun Ly Suwimon Khusuwan Tuti Parwati Merati Cuong Duy Do Evy Yunihastuti Iskandar Azwa Man Po Lee Thach Ngoc Pham Yu Jiun Chan Sasisopin Kiertiburanakul Oon Tek Ng Junko Tanuma Sanjay Pujari Fujie Zhang Yasmin Gani Vidya Mave Jeremy Ross Anchalee Avihingsanon P. S. Ly V. Khol F. J. Zhang H. X. Zhao N. Han M. P. Lee P. C.K. Li T. S. Kwong T. H. Li N. Kumarasamy C. Ezhilarasi S. Pujari K. Joshi S. Gaikwad A. Chitalikar S. Sangle V. Mave I. Marbaniang S. Nimkar D. N. Wirawan F. Yuliana A. Widhani S. Maria T. H. Karjadi J. Tanuma S. Oka T. Nishijima J. Y. Choi S. Na J. M. Kim N. B. Rudi A. Kamarulzaman S. F. SyedOmar S. Ponnampalavanar M. K. Pasayan M. L. Mationg W. W. Ku P. C. Wu E. Ke O. T. Ng P. L. Lim L. S. Lee T. Yap O. T. Ng A. Avihingsanon S. Gatechompol P. Phanuphak C. Phadungphon S. Kiertiburanakul A. Phuphuakrat L. Chumla N. Sanmeema R. Chaiwarith T. Sirisanthana J. Praparattanapan K. Nuket P. Payoong P. Kantipong P. Kambua T. N. Pham K. V. Nguyen D. T.H. Nguyen D. T. Nguyen C. D. Do A. V. Ngo L. T. Nguyen A. H. Sohn J. L. Ross B. Petersen Hospital Sungai Buloh Beijing Ditan Hospital Capital Medical University VHS Medical Centre India Gokila Bach Mai Hospital Universitas Udayana Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo The Kirby Institute National Center for Global Health and Medicine The HIV Netherlands Australia Thailand Research Collaboration Yonsei University College of Medicine Faculty of Medicine Ramathibodi Hospital, Mahidol University Queen Elizabeth Hospital Hong Kong University of Malaya Medical Centre Veterans General Hospital-Taipei Johns Hopkins University Faculty of Medicine, Chulalongkorn University Tan Tock Seng Hospital Chiang Mai University National Hospital for Tropical Diseases National Center for HIV/AIDS amfAR - The Foundation for AIDS Research Institute of Infectious Diseases Chiangrai Prachanukroh Hospital Medicine Objectives: We investigated weight changes following antiretroviral therapy (ART) initiation, the development of metabolic syndrome (MetS) and its association with all-cause mortality among Asian adults living with HIV. Methods: Participants enrolled in a regional Asian HIV-infected cohort with weight and height measurements at ART initiation were eligible for inclusion in the analysis. Factors associated with weight changes and incident MetS (according to the International Diabetic Federation (IDF) definition) were analysed using linear mixed models and Cox regression, respectively. Competing-risk regression models were used to investigate the association of MetS with all-cause mortality. Results: Among 4931 people living with HIV (PLWH), 66% were male. At ART initiation, the median age was 34 [interquartile range (IQR) 29–41] years, and the median (IQR) weight and body mass index (BMI) were 55 (48–63) kg and 20.5 (18.4–22.9) kg/m2, respectively. At 1, 2 and 3 years of ART, overall mean (± standard deviation) weight gain was 2.2 (±5.3), 3.0 (±6.2) and 3.7 (±6.5) kg, respectively. Participants with baseline CD4 count ≤ 200 cells/µL [weight difference (diff) = 2.2 kg; 95% confidence interval (CI) 1.9–2.5 kg] and baseline HIV RNA ≥ 100 000 HIV-1 RNA copies/mL (diff = 0.6 kg; 95% CI 0.2–1.0 kg), and those starting with integrase strand transfer inhibitor (INSTI)-based ART (diff = 2.1 kg; 95% CI 0.7–3.5 kg vs. nonnucleoside reverse transcriptase inhibitors) had greater weight gain. After exclusion of those with abnormal baseline levels of MetS components, 295/3503 had incident MetS [1.18 (95% CI 1.05–1.32)/100 person-years (PY)]. The mortality rate was 0.7 (95% CI 0.6–0.8)/100 PY. MetS was not significantly associated with all-cause mortality in the adjusted model (P = 0.236). Conclusions: Weight gain after ART initiation was significantly higher among those initiating ART with lower CD4 count, higher HIV RNA and an INSTI-based regimen after controlling for baseline BMI. Greater efforts to identify and manage MetS among PLWH are needed. 2022-08-04T04:29:24Z 2022-08-04T04:29:24Z 2022-03-01 Article HIV Medicine. Vol.23, No.3 (2022), 274-286 10.1111/hiv.13211 14681293 14642662 2-s2.0-85119685299 https://repository.li.mahidol.ac.th/handle/123456789/74780 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85119685299&origin=inward