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Overweight/Obesity Rate Rises After SVR in HCV/HIV-Coinfected People
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9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris
Mark Mascolini
Prevalence of overweight/obesity rose with time after sustained virologic response (SVR) in a French HCV/HIV cohort [1]. Cannabis users had almost 80% lower odds of overweight/obesity.
Curing HCV infection with direct-acting antivirals can ease the burden of comorbidities, which can be especially troubling in people coinfected with HIV. But the impact of HCV clearance on overweight or obesity remains unclear, even though overweight affects growing proportions of some HIV populations. To address this question, French researchers conducted this longitudinal study.
The analysis involved members of the ANRS CO13-HEPAVIH cohort, which consists of HCV/HIV-coinfected people. Cohort members who completed at least one self-administered questionnaire during the 2005-2014 follow-up period were eligible for this analysis. The researchers used annual body mass index measures to classify people as overweight/obese (BMI at or above 25 kg/m2). They used mixed logistic regression models to pinpoint predictors of overweight/obesity.
Of the 1046 people analyzed, 18.3% were overweight or obese at the start of follow-up. Age averaged 44.9 years (range 19 to 80), 69.9% of participants were men, and 72.2% currently smoked. Overweight/obesity prevalence was significantly higher in ex-smokers (29.4%) and nonsmokers (29.5%) than in current smokers (14.5%) (P = 0.0001). One third of these people (35.2%) reported hazardous alcohol consumption, and half (49.7%) used cannabis. Cannabis users had a significantly lower overweight/obesity prevalence than nonusers (9.7% versus 23.8%, P < 0.0001). Among people with 5 years of follow-up, 27% were overweight or obese.
In the multivariate analysis, HCV clearance by itself did not significantly affect odds of overweight/obesity. But the interaction between follow-up time and clearance indicated that longer time after clearance boosted odds of overweight/obesity about 75% (adjusted odds ratio [aOR] 1.74, 95% confidence interval [CI] 1.003 to 3.03, P = 0.049). Three other variables independently lowered odds of HCV clearance, female gender (aOR 0.43, 95% CI 0.25 to 0.71, P = 0.001), each year of antiretroviral therapy at the first visit (aOR 0.91, 95% CI 0.87 to 0.96, P = 0.0003), and cannabis use (aOR 0.22, 95% CI 0.08 to 0.61, P = 0.005).
The HEPAVIH team concluded that overweight/obesity prevalence is "not negligible" in HCV/HIV-coinfected people and tends to rise over time after SVR. The researchers see a need for better weight monitoring and weight-control interventions, particularly after HCV clearance.
Reference
1. Yaya I, Protopopescu C, Marcellin F, et al. Increased risk of overweightness and obesity after HCV clearance in patients co-infected with HIV and hepatitis C virus (HCV) (ANRS CO13-HEPAVIH cohort). 9th IAS Conference on HIV Science (IAS 2017), July 23-26, 2017, Paris. Abstract WEPEB0516.
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