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WEPE096 - Poster Exhibition
Obese HIV-positive persons have higher levels of select inflammatory markers and co-morbid illnesses
L. Conley1, T. Bush1, P. Patel1, J. Grubb2, J. Baker3, J. Hammer4, E. Kojic5, J. Brooks1, SUN Study Investigators
1Centers for Disease Control and Prevention, Atlanta, United States, 2Washington University, St. Louis, United States, 3University of Minnesota, Minneapolis, United States, 4Denver Infectious Disease Consultants, Denver, United States, 5Brown University, Providence, United States
Background: Obesity is increasingly common among HIV-infected persons in care. Before widespread use of combination antiretroviral therapy (cART), higher body mass index (BMI) was associated with higher CD4 cell counts, whereas associations of obesity with selected inflammatory markers among HIV-infected persons in the cART era have not been well described.
Methods: The Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy is an on-going prospective observational cohort study of 700 HIV-infected patients enrolled in four U.S. cities. Among the 494 virologically suppressed (HIV viral load < 400 copies/mL) participants whose baseline weight was normal (BMI=18.5 - 24.9 kg/m2), overweight (BMI=25.0 - 29.9 kg/m2) or obese (BMI ≥ 30.0 kg/m2), we assessed associations between BMI and markers of inflammation, carotid-intima media thickness (cIMT, a measure of atherosclerosis), and bone mineral density, using either the Student's t-test or Kruskal-Wallis test.
Results: Among 91 (18%) obese, 178 (36%) overweight, and 225 (46%) normal weight participants in this analysis, the percentage in each BMI category varied by gender and race/ethnicity (female: 48% vs. 14% vs. 16%, non-Hispanic black: 45% vs. 22% vs. 24%; both p< 0.001); however, median age (41 vs. 42 vs. 41 years, p=0.393), protease inhibitor use (42% vs. 40% vs. 41%, p=0.966), baseline (531 vs. 506 vs. 488 cells/mm3, p=0.540) and nadir CD4 cell counts (206 vs. 188 vs. 168 cells/mm3, p=0.504) did not differ. Compared to those with normal weight, obese participants had higher levels of many inflammatory markers (including high sensitivity C-reactive protein, D-dimer and interleukin-6) and greater cIMT but lower vitamin D levels despite lower rates of osteopenia/osteoporosis (Table).
Conclusions: In this contemporary, virologically suppressed HIV cohort, obese participants exhibited higher levels of markers of inflammation and atherosclerosis as well as lower vitamin D levels, despite a similar degree of immunosuppression compared with normal weight participants.
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