For Most, Starting HIV Treatment Is Associated With Weight Gain

[Jim Allen]

Ultimately some weight gain is preferable to what happens without treatment, No surprise here that starting treatment at a late stage so with low CD4 counts was the strongest factor seen and of course, lifestyle changes, adjusting diet and exercise to mitigate the gain.

An analysis of 4 studies, with a total of 5,680 participants started ARV treatment between 2003 and 2015. They were followed for more than 10,000 cumulative years of follow-up.

Full write-up https://www.poz.com/article/starting-hiv-treatment-associated-weight-gain

In Short:

Across all the studies, participants gained a median of 4.4 pounds after 96 weeks of treatment, with the greatest proportion of that weight gain occurring during the first 48 weeks. Through 96 weeks, the proportion of participants experiencing at least a 3%, 5% and 10% increase in weight was 48.6%, 36.6% and 17.3%, respectively.

Granted, 30.2% of participants lost weight.

Over time, the proportion of participants who fell into the overweight and obese BMI ranges increased.

After adjusting the data to account for various differences between the study participants, the researchers found that baseline CD4 count was the factor most strongly associated with weight gain. Those who had an initial CD4 count below 200 gained an average of 6.5 pounds more after 96 weeks than those with an initial CD4 count of at least 200. There was a close correlation between increases in CD4 count and weight over time while individuals were on ARVs.

Having a baseline viral load above 100,000 was associated with a 2.1-pound greater average weight gain compared with initially having a viral load below that threshold. Those starting with symptomatic HIV or AIDS gained an average of 1.1 more pounds than those with asymptomatic HIV. Those who did not inject drugs gained an average of 3.1 pounds more than those who did. Black individuals gained 2.2 pounds more on average than non-Blacks.

Being female, younger than 50 years old and starting on ARVs with an obese BMI were all associated with smaller yet significantly greater weight gain.

Stratifying their results by both sex and race, the investigators found that Black women had the greatest average weight gain on ARVs, followed by Black men.

Looking at the third ARV in individuals’ HIV regimens, whether integrase inhibitors, non-nucleoside reverse transcriptase inhibitors (NNRTIs) or protease inhibitors, the investigators found average weight gains of 7.1 pounds, 4.2 pounds and 3.8 pounds, respectively.

“Our findings raise the possibility that modern [ARV treatment] regimens with improved tolerability and potency may lead to weight gain in some [people with HIV], necessitating increased clinical attention to the maintenance of healthy body weight, lifestyle modification and exercise at [treatment] initiation,” the study authors concluded.

[fabio]

I think in general feeling unwell and sick makes you lose weight.
I had noticed that before my diagnosis I would feel exhausted and didn't have much energy or appetite. After treatment I got a boost on my energy and didn't sleep through the whole day.
It definitely affects appetite and energy levels.

[Jim Allen]

I think in general feeling unwell and sick makes you lose weight.
I had noticed that before my diagnosis I would feel exhausted and didn't have much energy or appetite. After treatment I got a boost on my energy and didn't sleep through the whole day.
It definitely affects appetite and energy levels.

Yeah, very true for some this would be a thing, gaining weight when recovering after being unwell.