Frontiers in Immunology (Nov 2014)

Increasing obesity in treated female HIV patients from Sub-Saharan Africa: Potential causes and possible targets for intervention

  • Claire eMcCormick,
  • Arianne M Francis,
  • Kim eIliffe,
  • Helen eWebb,
  • Catherine J Douch,
  • Mark ePakianathan,
  • Derek eMacallan,
  • Derek eMacallan

DOI
https://doi.org/10.3389/fimmu.2014.00507
Journal volume & issue
Vol. 5

Abstract

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Objectives To investigate changing nutritional demographics of treated HIV-1-infected patients and explore causes of obesity, particularly in women of African origin.Methods We prospectively reviewed nutritional demographics of clinic attenders at an urban European HIV clinic during four one-month periods at 3-yearly intervals (2001, 2004, 2007, and 2010) and in two consecutive whole-year reviews (2010-11 and 2011-12). Risk-factors for obesity were assessed by multiple linear regression. A sub-study of 50 HIV-positive African female patients investigated body-size/shape perception using numerical, verbal and pictorial cues. Results We found a dramatic rise in the prevalence of obesity (BMI >30 kg/m2), from 8.5% (2001) to 28% (2011-12) for all clinic attenders, of whom 86% were on antiretroviral treatment. Women of African origin were most affected, 49% being obese, with a further 32% overweight (BMI 25-30 kg/m2), in 2012. Clinical factors strongly associated with obesity included female gender, black African ethnicity, non-smoking, age and CD4 count (all P<0.001); greater duration of cART did not predict obesity. Individual weight-time trends mostly showed slow long-term progressive weight gain. Investigating body weight perception, we found that weight and adiposity were underestimated by obese subjects, who showed a greater disparity between perceived and actual adiposity (P<0.001). Obese subjects targeted more obese target ideal body shapes (P<0.01), but were less satisfied with their body shape overall (P=0.02). Conclusions Seropositive African women on antiretroviral treatment are at heightened risk of obesity. Although multifactorial, bodyweight perception represents a potential target for intervention.

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