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WEIGHT GAIN POST-ART IN HIV+ LATINOS/AS DIFFERS IN THE USA, HAITI, AND LATIN AMERICA
https://www.arca.fiocruz.br/handle/icict/64967
Autor
Coelho, Lara E.
Jenkins, Cathy A.
Shepherd, Bryan E.
Pape, Jean W.
Cordero, Fernando Mejia
Padgett, Denis
Ramirez, Brenda Crabtree
Grinsztejn, Beatriz
Althoff, Keri N.
Koethe, John R.
Marconi, Vincent C.
Tien, Phyllis C.
Willig, Amanda L.
Moore, Richard D.
Castilho, Jessica L.
Colasanti, Jonathan
Crane, Heidi M.
Gill, M. John
Horberg, Michael A.
Mayor, Angel
Silverberg, Michael J.
McGowan, Catherine
Rebeiro, Peter F.
Jenkins, Cathy A.
Shepherd, Bryan E.
Pape, Jean W.
Cordero, Fernando Mejia
Padgett, Denis
Ramirez, Brenda Crabtree
Grinsztejn, Beatriz
Althoff, Keri N.
Koethe, John R.
Marconi, Vincent C.
Tien, Phyllis C.
Willig, Amanda L.
Moore, Richard D.
Castilho, Jessica L.
Colasanti, Jonathan
Crane, Heidi M.
Gill, M. John
Horberg, Michael A.
Mayor, Angel
Silverberg, Michael J.
McGowan, Catherine
Rebeiro, Peter F.
Afiliación
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Groupe Haitien d'Etudes du Sarcome de Kaposi et des Infections Opportunistes. Port-au-Prince, Haiti.
Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.
Instituto Hondureño de Seguridad Social & Hospital Escuela Universitario. Tegucigalpa, Honduras.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Deparatmento de Infectologia. Mexico City, Mexico.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Johns Hopkins University. Baltimore, MD, USA.
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Emory University School of Medicine and Rollins School of Public Health. Atlanta, GA, USA.
University of California San Francisco. Department of Medicine, and the Department of Veterans Affairs Medical Center. San Francisco, CA, USA.
University of Alabama at Birmingham. School of Medicine. Birmingham, AL, USA.
Johns Hopkins University. Baltimore, MD, USA.
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Emory University School of Medicine and Rollins School of Public Health. Atlanta, GA, USA.
University of Washington. Seattle, WA, USA.
The University of Calgary. Calgary, AB, Canada.
Kaiser Permanente. Mid-Atlantic Permanente Research Institute. Rockville, MD, US.
Universidad Central del Caribe. Retrovirus Research Center. Bayamón, PR, US.
Kaiser Permanente Northern California. Oakland, CA, US.
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA / Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA.
Groupe Haitien d'Etudes du Sarcome de Kaposi et des Infections Opportunistes. Port-au-Prince, Haiti.
Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.
Instituto Hondureño de Seguridad Social & Hospital Escuela Universitario. Tegucigalpa, Honduras.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Deparatmento de Infectologia. Mexico City, Mexico.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Johns Hopkins University. Baltimore, MD, USA.
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Emory University School of Medicine and Rollins School of Public Health. Atlanta, GA, USA.
University of California San Francisco. Department of Medicine, and the Department of Veterans Affairs Medical Center. San Francisco, CA, USA.
University of Alabama at Birmingham. School of Medicine. Birmingham, AL, USA.
Johns Hopkins University. Baltimore, MD, USA.
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Emory University School of Medicine and Rollins School of Public Health. Atlanta, GA, USA.
University of Washington. Seattle, WA, USA.
The University of Calgary. Calgary, AB, Canada.
Kaiser Permanente. Mid-Atlantic Permanente Research Institute. Rockville, MD, US.
Universidad Central del Caribe. Retrovirus Research Center. Bayamón, PR, US.
Kaiser Permanente Northern California. Oakland, CA, US.
Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Vanderbilt University Medical Center. Department of Biostatistics. Nashville, TN, USA / Vanderbilt University Medical Center. Division of Infectious Diseases. Nashville, TN, USA.
Resumen en ingles
Background: An obesity epidemic has been documented among adult Latinos/as in Latin America and the United States (US); however, little is known about obesity among Latinos/as with HIV (PWH). Moreover, Latinos/as PWH in the US may have different weight trajectories than those in Latin America due to the cultural and environmental contexts. We assessed weight and body mass index (BMI) trajectories among PWH initiating antiretroviral therapy (ART) across 5 countries in Latin America and the Caribbean and the US. Methods: ART-naÿve PWH ≥18 years old, enrolled in Brazil, Honduras, Mexico, Peru, and Haiti (sites within CCA-SAnet) and the US (NA-ACCORD) starting ART between 2000 and 2017, with at least one weight measured after ART initiation were included. Participants were classified according to site/ethnicity as: Latinos/as in US, non-Latinos/as in US, Haitians, and Latinos/as in Latin America. Generalized least squares models were used to assess trends in weight and BMI. Models estimating probabilities of becoming overweight/obese (BMI ≥25 kg/m2) and of becoming obese (BMI ≥30 kg/m2) post ART initiation for males and females were fit using generalized estimating equations with a logit link and an independence working correlation structure. Findings: Among 59,207 PWH, 9% were Latinos/as from Latin America, 9% Latinos/as from the US, 68% non-Latinos/as from the US and 14% were Haitian. At ART initiation, 29% were overweight and 14% were obese. Post-ART weight and BMI increases were steeper for Latinos/as in Latin America compared with other sites/ethnicities; however, BMI at 3-years post ART remained lower compared to Latinos/as and non-Latinos/as in the US. Among females, at 3-years post ART initiation the greatest adjusted probability of obesity was found among non-Latinas in the US (15·2%) and lowest among Latinas in Latin America (8.6%). Among males, while starting with a lower BMI, Latinos in Latin America had the greatest adjusted probability of becoming overweight or obese 3-years post-ART initiation. Interpretation: In the Americas, PWH gain substantial weight after ART initiation. Despite environmental and cultural differences, PWH in Latin America, Haiti and Latinos and non-Latinos in the US share similar BMI trajectories on ART and high probabilities of becoming overweight and obese over time. Multicohort studies are needed to better understand the burden of other metabolic syndrome components in PWH across different countries.
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