TY - JOUR
T1 - Clinical factors associated with weight loss related to infection with human immunodeficiency virus type 1 in the multicenter AIDS cohort study
AU - Graham, Neil M.H.
AU - Muñoz, Alvaro
AU - Bacellar, Helena
AU - Kingsley, Lawrence A.
AU - Visscher, Barbara R.
AU - Phair, John P.
N1 - Funding Information:
6 Department of Epidemiology, School of Public Health, Uruversrty of California, Los Angeles, Los Angeles, CA 8 Howard Brown Memorial Clinic and Northwestern University Medical School, Chicago, L Participating centers and investigators The Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD A Saah, H Farzadegan, N U H Graham, J Margolick, and J McArthur, Howard Brown Memorial Clinic and Northwestern University Medical School, Chicago, IL J P Phair. J S Chmiel, B Cohen, K Shendan, S Wolmsky, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA C R Rmaldo, P Gupta, M Ho, L A Kmgsley, and A Winkelstein, Schools ol Public Health and Medicine, University ol California, Los Angeles, CA R Detels, B R vlsscher, J Dudtey, J L Fahey, J V Giorgi, D Imagawa, J Taylor, and P Ntshanian, National Institute of Allergy and Infectious Diseases, Bethesda, MD S H Vermund, L K Schrager, R A Kasiow, and M J van Raden, National Cancer Institute, Bethesda, MD I Obrams Data Coordinating Center The Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD A Mufioz, D R Hoover, L P Jacobson, N Galai, L Park, andS Su Reprint requests to Dr N M H Graham, Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health, 624 N Broadway, Baltimore, MD 21205 This study was supported by NIH research contracts NO1-A1 -72634, 72676, 32535, 72631 and 72632 The authors would like to thank Ms llene Speizer for help with data analysis and Ms Harriet Grossman for assisting with the preparation of the manuscript
PY - 1993/2/15
Y1 - 1993/2/15
N2 - The relation between a number of potential risk factors and change in body mass index per semester was examined in a community-based cohort of 1,809 homosexsual and bisexual men seropositive for human immunodeficiency virus type 1 (HIV-1). The men were followed semiannually for up to 6.5 years between 1984 and 1990. A total of 9,735 person-semesters of observations were available for analysis. A Markov-type autoregressive model, adjusting for previous body mass index, was used to predict the change in body mass index over each person-semester. Overall, the cohort was gaining weight An asymptomatic participant 1.8m in height whose CD4+cell count was >750/μl gained a mean of 0.5 kg each person-semester. In bivariate autoregressive models, diarrhea, fever, oral thrush, acquired immunodeficiency syndrome (AIDS), and CD4+lymphocyte counts of <100 and 100-199 cell/μl were all associated with a significant decrease in body mass index. A significant inverse association was also found between change in body mass index and lymphadenopathy and herpes zoster, but when the intercept coefficient was added, no overall decrease in body mass index was seen in these models. In a final multivarite model, diarrhea was less strongly associated with a change in body mass index (p = 0.057), althougth AIDS (p = 0.009), fever (p = 0.006), thrush (p = 0.002), and a CD4+lymphocyte count of <100 cell/μl (p < 0.001)all remained independently associated with a decrease in body mass index. Lymphadenopathy and a CD4+ lymphocyte count of 100-199 cells/μl were also significant covariates in the final model, but neither of the beta coefficients exceeded that of the intercept, indicating that they were not independently associated with a decrease in body mass index. These findings suggest that the importance of diarrhea as a cause of HIV-related weight loss may have been over -estimated in previous clinic-based studies. AIDS and nonspecific markers of progression (fever, thrush, and a CD4+ count of <100 cells/μl) were the best predictors of weight loss during a semester.
AB - The relation between a number of potential risk factors and change in body mass index per semester was examined in a community-based cohort of 1,809 homosexsual and bisexual men seropositive for human immunodeficiency virus type 1 (HIV-1). The men were followed semiannually for up to 6.5 years between 1984 and 1990. A total of 9,735 person-semesters of observations were available for analysis. A Markov-type autoregressive model, adjusting for previous body mass index, was used to predict the change in body mass index over each person-semester. Overall, the cohort was gaining weight An asymptomatic participant 1.8m in height whose CD4+cell count was >750/μl gained a mean of 0.5 kg each person-semester. In bivariate autoregressive models, diarrhea, fever, oral thrush, acquired immunodeficiency syndrome (AIDS), and CD4+lymphocyte counts of <100 and 100-199 cell/μl were all associated with a significant decrease in body mass index. A significant inverse association was also found between change in body mass index and lymphadenopathy and herpes zoster, but when the intercept coefficient was added, no overall decrease in body mass index was seen in these models. In a final multivarite model, diarrhea was less strongly associated with a change in body mass index (p = 0.057), althougth AIDS (p = 0.009), fever (p = 0.006), thrush (p = 0.002), and a CD4+lymphocyte count of <100 cell/μl (p < 0.001)all remained independently associated with a decrease in body mass index. Lymphadenopathy and a CD4+ lymphocyte count of 100-199 cells/μl were also significant covariates in the final model, but neither of the beta coefficients exceeded that of the intercept, indicating that they were not independently associated with a decrease in body mass index. These findings suggest that the importance of diarrhea as a cause of HIV-related weight loss may have been over -estimated in previous clinic-based studies. AIDS and nonspecific markers of progression (fever, thrush, and a CD4+ count of <100 cells/μl) were the best predictors of weight loss during a semester.
KW - Acquired immunodeficiency syndrome
KW - Diarrhea
KW - HIV infections
KW - Weight loss
UR - http://www.scopus.com/inward/record.url?scp=0027536778&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027536778&partnerID=8YFLogxK
U2 - 10.1093/oxfordjournals.aje.a116692
DO - 10.1093/oxfordjournals.aje.a116692
M3 - Article
C2 - 8096357
AN - SCOPUS:0027536778
VL - 137
SP - 439
EP - 446
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 4
ER -