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Trends and risk factors for obesity among HIV positive Nigerians on antiretroviral therapy

Authors:

L O Ezechi,

Department of Home Economics, Federal College of Education (Technical), Yaba Lagos, NG
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Z A Musa,

Maternal, Reproductive and Child Health Research Group, Nigerian Institute of Medical Research, Lagos, NG
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V O Otobo,

Department of Home Economics, Federal College of Education (Technical), Yaba Lagos, NG
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I E Idigbe,

Maternal, Reproductive and Child Health Research Group, Nigerian Institute of Medical Research, Lagos, NG
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O C Ezechi

Maternal, Reproductive and Child Health Research Group, Nigerian Institute of Medical Research, Lagos, NG
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Abstract

Introduction The increased access to antiretroviral therapy has changed the once deadly infection to a chronic medical condition, resulting in a dramatic change in causes of morbidity and mortality among HIV infected individuals. Obesity and its cardiovascular sequelae are increasingly reported in the literature. However, data on the burden, trends and risk factors for obesity are sparse in countries worst hit by the epidemic.

Objectives To investigate the trend and risk factors for obesity among a cohort of HIV infected adults on antiretroviral therapy.

Methods We analysed prospectively collected data in an ongoing longitudinal observational study conducted at the HIV treatment centre, Nigerian Institute of Medical Research, Lagos, Nigeria. Patients who started treatment between June 2004 and December 2009, and completed a five year follow up were included in the analysis. Multivariate analysis was used to determine the risk factors for obesity among the cohort.

Results A total of 12 585 adults were enrolled in the treatment programme during the study period. Of which, 8819 (70.1%) met the inclusion criteria. At the start of treatment, 27.0% were either overweight (19.6%) or obese (7.4%) compared to 62.2% that were either overweight (35.7%) or obese (26.5%) at the end of 5 years. The observed differences were statistically significant (p<0.01). Female gender (aOR: 2.2; 95% CI: 1.81-2.67), low baseline BMI less than 20 (aOR: 1.9; 95% CI: 1.3-2.2) and baseline CD4 count less than 350/ìl (aOR: 2.51; 95% CI: 2.13 – 3.09) were associated with the development of obesity at multivariate analysis. Type of antiretroviral drug, age, marital status, viral load and haemoglobin level were not associated with obesity after controlling for confounding variables.

Conclusions Obesity is common among HIV infected Nigerians on antiretroviral therapy and is associated with female gender, low baseline BMI, and CD4 count less than 350/ìl. Programmes targeted at prevention of obesity and its sequelae should be integrated into routine HIV care with emphasis on those with the identified risk factors.    

DOI: https://doi.org/10.4038/cmj.v61i2.8300
How to Cite: Ezechi, L.O., Musa, Z.A., Otobo, V.O., Idigbe, I.E. and Ezechi, O.C., 2016. Trends and risk factors for obesity among HIV positive Nigerians on antiretroviral therapy. Ceylon Medical Journal, 61(2), pp.56–62. DOI: http://doi.org/10.4038/cmj.v61i2.8300
Published on 23 Jun 2016.
Peer Reviewed

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