Date of Award

1-1-2013

Document Type

Open Access Dissertation

Department

Epidemiology and Biostatistics

Sub-Department

Epidemiology

First Advisor

Anwar Merchant

Abstract

Highly active antiretroviral treatment (HAART) has transformed the state of human immunodeficiency virus (HIV) from acute to chronic. As a result, the long-term effect of HAART has caused weight gain among HIV-infected individuals, leading to an increased prevalence of overweight and obesity. Increased Body Mass Index (BMI) has been associated with adverse health outcomes in non-HIV and HIV populations, yet among HIV-infected individuals, a higher BMI at diagnosis offers a slower progression from HIV to AIDS. Pre-HAART, studies reported that obese HIV-infected individuals have higher increases in CD4 count over time. However post-HAART, some report that overweight HIV-infected individuals with a higher BMI experience increased CD4 counts. In addition, HIV-infected treated individuals are now experiencing cardiovascular disease outcomes. Therefore, additional research is needed to support current evidence. Given that our study population consists of individuals from South Carolina, a state with a high prevalence of HIV and obesity, it is beneficial to explore the relationship between BMI at diagnosis and markers for HIV progression and cardiovascular disease risk. This cohort study consisted of 396 HIV-infected adults from the Ryan White Clinic in SC. The objectives of this study were to evaluate the relationship between BMI at diagnosis and CD4 count over time, to evaluate this relationship by gender, and to evaluate the relationship between BMI at diagnosis and cardiovascular disease risk markers (high-density lipoprotein(HDL), low-density lipoprotein (LD), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose).

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