Association between obesity and combination antiretroviral therapy (cART) adherence among persons with early-stage HIV infection initiating cART
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Date
2021Author
Musinguzi, Nicholas
Stanford, Fatima Cody
Boatin, Adeline A.
Orrell, Catherine
Asiimwe, Stephen
Siedner, Mark
Haberer, Jessica E.
on behalf of the META team
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Background: Obesity is common among people living with HIV (PLWH) and early-stage infection, yet associations with combination antiretroviral (cART) adherence are unclear.
Methods: Among PLWH initiating cART in Uganda and South Africa, body mass index (BMI) was assessed at cART initiation, and cART adherence was monitored in real-time over 12 months. The association of obesity (BMI≥30kg/m2) with adherence was assessed among non-pregnant participants with CD4>350 cells/mm3 using fractional regression modeling.
Results: Among 322 participants, median age was 32 years, 70% were female, and 54% were from Uganda. Prevalence of obesity was 12% in Uganda and 28% in South Africa. Mean overall cART adherence was 83% in Uganda and 66% in South Africa. Participants with obesity had higher adherence than those without obesity: +3.6% (p=0.44) in Uganda and +11.4% (p=0.02) in South Africa.
Conclusion: Obesity at cART initiation was common and associated with higher adherence, although only significantly in South Africa.
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