Association between obesity and combination antiretroviral therapy (cART) adherence among persons with early-stage HIV infection initiating cART

Int J Obes (Lond). 2021 Aug;45(8):1855-1859. doi: 10.1038/s41366-021-00837-y. Epub 2021 May 18.

Abstract

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 ≥ 30 kg/m2) with adherence was assessed among nonpregnant 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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active*
  • Assessment of Medication Adherence*
  • Female
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Male
  • Obesity* / complications
  • Obesity* / epidemiology
  • South Africa / epidemiology
  • Uganda / epidemiology

Substances

  • Anti-Retroviral Agents