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Weight Gain After Antiretroviral Therapy Initiation and Subsequent Risk of Metabolic and Cardiovascular Disease
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15 February 2024
Sara H. Bares,1, Xingye Wu,2 Katherine Tassiopoulos,3 Jordan E. Lake,4 Susan L. Koletar,5 Robert Kalayjian,6 and Kristine M. Erlandson7; for the A5322 Study Team
Abstract
Background
Weight gain following initiation of antiretroviral therapy (ART) is common. We assessed the impact of changes in weight in the year following ART initiation with subsequent cardiometabolic disease among AIDS Clinical Trials Group (ACTG) participants.
Methods
Linear regression models were fit to examine the association between change in weight/waist circumference (WC) in weeks 0–48 and change in metabolic parameters in weeks 0–48 and 48–96. Cox proportional hazard models were fit to examine the association between changes in weight/WC in weeks 0–48 and diabetes mellitus (DM), metabolic syndrome, or cardiometabolic and cardiovascular events after week 48.
Results
Participants (N = 2624) were primarily male (81%) and non-White (60%).
Mean weight gain from 0–48 weeks was 3.6 kg (SD 7.3);
130 participants developed DM;
360 metabolic syndrome;
424 any cardiometabolic event;
28 any cardiovascular event, over 480 weeks of follow-up.
Conclusions
Weight and body composition changes in the first year following ART initiation are associated with contemporaneous changes in metabolic parameters and subsequent cardiometabolic disease.
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