Anthropometric differences between HIV-infected individuals prior to antiretroviral treatment and the general population from 1998-2007: the AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT) cohort and NHANES

Benjamin E Atkinson, Supriya Krishnan, Gary Cox, Todd Hulgan, Ann C Collier, Benjamin E Atkinson, Supriya Krishnan, Gary Cox, Todd Hulgan, Ann C Collier

Abstract

Objective: To assess differences in body circumferences and body mass index (BMI, kg/m(2)) between antiretroviral treatment (ART) naïve HIV-infected and HIV-uninfected persons.

Methods: Waist, arm, and thigh circumferences and BMI were measured within the ALLRT and NHANES cohorts between 1998 and 2007. ALLRT is a prospective, longitudinal study of U.S. participants enrolled in randomized HIV treatment studies conducted by the AIDS Clinical Trials Group (ACTG). NHANES is a representative group of the US population. The cohorts were analyzed in two time periods, to account for trends towards increased adiposity. Anthropometrics were displayed in percentiles by age and sex. Multiple linear regression models examined differences between cohorts.

Results: ALLRT had more males (82% versus 48%, p<0.0001), more black participants (32% versus 23%, p<0.0001), and less Hispanics (21% versus 30%, p<0.0001) than NHANES. Mean BMI was smaller in ALLRT males and females compared to NHANES by 1.6-2.4 kg/m(2) (p<0.0001). Mean waist and arm circumferences in both sexes and time periods were significantly smaller in ALLRT than in NHANES (p<0.0001). Mean thigh circumference in ALLRT was also smaller than NHANES among males (p<0.0001 in both time periods) and females (p = 0.01 in the early time period).

Conclusions: Differences in anthropometrics existed prior to ART initiation, in this large national cohort of HIV-infected individuals, compared to a representative HIV-uninfected cohort, indicating that HIV and its complications have important effects on body shape. Further longitudinal examination of anthropometrics in this HIV-infected cohort may provide additional insight into disease risk.

Trial registration: NCT00001137 at www.clinicaltrials.gov.

Conflict of interest statement

Competing Interests: TH has received research funding from Merck & Co. ACC has received past research support from Tibotec, Merck Laboratories, Schering-Plough, Boehringer-Ingelheim, and Gilead Sciences; and current research support from Merck and Co. ACC was a member of a DSMB for a Merck-sponsored study. She had equity in Bristol-Myers Squibb, Abbott Laboratories, Johnson and Johnson and Pfizer in the past. The remaining authors claim no competing interests. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1. Flow diagram.
Figure 1. Flow diagram.
NHANES: National Health and Nutrition Examination Survey ALLRT: AIDS Clinical Trials Group Longitudinal Linked Randomized Trials.
Figure 2. Mean (95% CI) anthropometrics among…
Figure 2. Mean (95% CI) anthropometrics among males, adjusted* for age, race, √height, smoking history and diabetes history.
NHANES: National Health and Nutrition Examination Survey ALLRT: AIDS Clinical Trials Group Longitudinal Linked Randomized Trials *Age centered at 40 years; reference for race is white; reference for smoking history is non-smoker; reference for diabetes history is no diabetes history. BMI not adjusted for √height. a NHANES significantly different from ALLRT (p<0.0001). b Significantly different from 1st time period (p≤0.05). c Significantly different from 1st time period (p≤0.0001).
Figure 3. Mean (95% CI) anthropometrics among…
Figure 3. Mean (95% CI) anthropometrics among females, adjusted* for age, race, √height, smoking history and diabetes history.
NHANES: National Health and Nutrition Examination Survey ALLRT: AIDS Clinical Trials Group Longitudinal Linked Randomized Trials *Age centered at 40 years; reference for race is white; reference for smoking history is non-smoker; reference for diabetes history is no diabetes history. BMI not adjusted for √height. a NHANES significantly different from ALLRT (p<0.0001). b Significantly different from 1st time period (p = 0.02). c Significantly different from 1st time period (p<0.0001). d NHANES significantly different from ALLRT (p = 0.01). e NHANES significantly different from ALLRT (p = 0.03).

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