Abstract
Objectives: In the general population, metabolic health often declines as BMI increases. However, some obese individuals maintain metabolic health. HIV and antiretroviral therapy have been associated with metabolic disturbances. We hypothesized that HIV-infected (HIV +) men on suppressive antiretroviral therapy experience less metabolic health than HIV-uninfected (HIV-) men across all BMI categories. Design/methods: In a cross-sectional analysis of 1018 HIV + and 1092 HIV-men enrolled in the multicenter AIDS cohort study, Poisson regression with robust variance determined associations between HIV serostatus and metabolic health prevalence (defined as meeting ≤2 of 5 National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria), adjusting for age, race, BMI category, smoking, and hepatitis C virus infection status. Results: HIV + men were younger (54 vs. 59 years) and had lower median BMI (25 vs. 27 kg/m 2). Nonobese HIV + men had lower metabolic health prevalence than HIV-men (BMI ≤25 kg/m 2: 80 vs. 94%, P < 0.001; BMI 25-29 kg/m 2: 64 vs. 71%, P = 0.05), but metabolic health prevalence among obese men did not differ by HIV serostatus (BMI 30-34 kg/m 2: 35 vs. 39%, P = 0.48; BMI ≥35 kg/m 2: 27 vs. 25%, P = 0.79). In the adjusted model, nonobese HIV + men were less likely to demonstrate metabolic health than nonobese HIV-men. Among HIV + men, per year darunavir, zidovudine, and stavudine use were associated with lower metabolic health likelihood. Conclusion: Metabolically healthy obesity prevalence does not differ by HIV serostatus. However, among nonobese men, HIV infection is associated with lower metabolic health prevalence, with associations between lack of metabolic health and darunavir and thymidine analog nucleoside reverse transcriptase inhibitor exposure observed.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 49-57 |
| Number of pages | 9 |
| Journal | AIDS |
| Volume | 32 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2 2018 |
Funding
Data in this manuscript were collected by the MACS. MACS (Principal Investigators): Johns Hopkins University (JHU) Bloomberg School of Public Health (Joseph Margolick), U01-AI35042; Northwestern University (Steven Wolinsky), U01-AI35039; University of California, Los Angeles (Roger Detels), U01-AI35040; University of Pittsburgh (Charles Rinaldo), U01-AI35041; the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson), UM1-AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases, with additional cofunding from the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute of Mental Health. Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute and the National Institute on Deafness and Communication Disorders. MACS data collection is also supported by UL1-TR001079 (JHU Institute for Clinical and Translational Research) from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the NIH, the JHU Institute for Clinical and Translational Research or the National Center for Advancing Translational Sciences. The MACS website is located at http://aidscohortstudy.org/. Additional research support provided by the National Institutes of Health grants U01 Al035040, R01 HL095129, UL1TR000124, P30 AG028748, K24 AI120834, K23 AG050260 and K23 AI110532–01A1 and the US Department of Health and Human Services contract number HHSN272200800014C.
Keywords
- HIV
- darunavir
- metabolic syndrome
- metabolically healthy obesity
- obesity
- thymidine analog
ASJC Scopus subject areas
- Infectious Diseases
- Immunology and Allergy
- Immunology
