Publication Abstract Display
Type: Published Manuscript
Title: Body Mass Index and cognitive function among HIV-1 infected individuals in China, India and Nigeria.
Authors: Jumare J, El-Kamary SS, Magder L, Hungerford L, Umlauf A, Franklin D, Ghate M, Abimiku A, Charurat M, Letendre S, Ellis RJ, Mehendale S, Blattner WA, Royal W, Marcotte TD, Heaton RK, Grant I, McCutchan JA
Year: 2019
Publication: Journal of Acquired Immune Deficiency Syndromes (1999)
Volume: 80 Issue: 2 Pages: e30-e35
Abstract:BACKGROUND: Risk of cognitive impairment is increased among persons with high or low body mass index (BMI) in HIV- and HIV+ populations in resource-rich settings. We examined this association among HIV+ patients in three resource-limited settings. METHODS: This secondary analysis included data of 761 HIV+ volunteers pooled from 3 prospective cohort studies conducted in China (n=404; 53%), India (n=200; 26%) and Nigeria (n=157; 21%). World Health Organization (WHO) weight classifications were based on BMI. T scores, adjusted for demographics and practice effects, were derived from a 7-domain neuropsychological battery. Neurocognitive impairment (NCI) was defined as global deficit score (GDS) of ≥ 0.5. RESULTS: Overall prevalence of NCI at baseline was 27.7% (similar across all cohorts). The overweight/obese and underweight constituted 37.3% and 15.5% of the total participants respectively. In a multivariable logistic regression of pooled longitudinal data, adjusting for clinical and demographic variables, the odds of global neurocognitive impairment were 38% higher among the overweight/obese as compared to normal weight participants (OR: 1.38 [95% CI: 1.1, 1.72]; P=0.005). Similarly, the odds of global neurocognitive impairment were 39% higher among the underweight as compared to normal weight participants (OR: 1.39 [95% CI: 1.03, 1.87]; P=0.029). CONCLUSION: Neurocognitive impairment among HIV-1 infected patients was more prevalent in both overweight/obese and underweight than normal weight individuals in three resource-limited settings, confirming observations in resource rich settings. Mechanisms underlying these associations are unclear, but likely differ for underweight and overweight persons.

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