Weight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, Rwanda

Griensven, Johan van; Zachariah, Rony; Mugabo, Jules; Reid, Tony

doi:10.1016/j.trstmh.2010.08.016

Cited by 17 publications

(18 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar findings were recently reported in Ethiopia, which underscores the fact that beyond adherence to an effective ART-regimen, malnutrition remains a threat that deserves special considerations [29]. The fact that weight loss was found in 40% of our participants confirms the uniqueness of HIV infection in inducing a progressive decline of body weight [30,31]. Our data also revealed that about three quarters of participants lived on an average daily ration that range between $2 and $10 per day, and only half of participants could afford 2 meals per day, which in turn justifies the profile of WLP and highlights the financial constraint HIV could have on food insecurity among Cameroonian families [32].…”

Section: Discussionsupporting

confidence: 87%

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Abba

Fokam

Kamgaing

et al. 2020

Preprint

View full text Add to dashboard Cite

31 Background: HIV management remains concerning and even more challenging in the frame of 32 comorbidities like malnutrition that favors disease progression and mortality in resource-limited settings 33 (RLS). 34 Objective: To evaluate the correlation between immuno-virological responses and the nutritional profile 35 of HIV-infected individuals receiving antiretroviral therapy (ART).36 Methods: A cross-sectional study was conducted from October to December 2018 among 146 consenting 37 participants enrolled in two health facilities of the East-Region of Cameroon. Socio-demographic data, 38 basic clinical information and treatment history were collected; blood samples were collected by 39 venipuncture for laboratory analysis (HIV-1 viral load, CD4-CD8 Tcells measurement and biochemical 40 analysis) performed at the "Chantal Biya" International Reference Center", Yaounde, Cameroon. 41 Nutritional profile was evaluated using anthropometric and biochemical parameters. Data were analyzed 42 using Excel 2016, Graph pad prism version 6 and R.version3.5.0; Spearman correlation was used; with 43 p<0.05 considered statistically significant.44 Results: Median [IQR] age was 42 [33-51] years, 76.0% ( 111/146) were female and median [IQR]45 duration on ART was 54 [28-86] months. Of these participants, 11.6% ( 17/146) were underweight based 46 on the body mass index and 4.7% (7/146) were at the stage of advanced weight loss. According to 47 immunovirological responses, 44.5% (65/146) were immunocompromised (CD4<500 cell/µl) and 75.3% 48 (110/146) had an undetectable viremia (<40 copies/mL). CD4 count inversely correlated with total protein 49 concentration (r=-0.18, p=0.030) and viremia was inversely correlated with total cholesterol (r=-0.65; 50 p=0.001), and positively correlated with total protein (r=0.28; p<0.001) and seemingly with triglycerides 51 (r=0.27; p=0.070) concentrations. 52 Conclusion: In this RLS with patients having about five years of ART-experience, half are 53 immunocompromised while the majority have achieved good virological response. Interestingly, one out 54 of eight patients might be experiencing malnutrition. Specifically, increasing CD4 may favour hypo-55 proteinemia while increasing viral load may prone hyper-proteinemia and hypo-cholesterolemia. Further 56 studies are needed in RLS with high burden of HIV-infection.

show abstract

Section: Discussionsupporting

confidence: 87%

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Abba

Fokam

Kamgaing

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…A study from Rwanda also showed that with D4T based ART a high proportion of patients had a progressive decline of body weight in the second year of treatment. 12 There is not enough data available in our study to fully explain this weight loss. There was however a difference in total weight change after 2 years of treatment according to the antiretroviral drugs in the initial regimen, with in the NRTI-category the highest weight gain in patients on a TDF-containing regimen.…”

Section: Discussionmentioning

confidence: 81%

“…This corresponds to the findings of van Griensven et al, who showed that being female, a longer duration of ART, a baseline BMI ≥25 kg/m 2 a D4T-based ART-regimen (compared to an AZT-based regimen), but also (in contrast to our findings) a baseline CD4 cell count ≥150 cells/µL, were significantly associated with lipoatrophy. 12 A South African study showed that lactic acidosis, another consequence of mitochondrial toxicity, was also associated with female gender, increased BMI and D4T therapy. 14 …”

Section: Discussionmentioning

confidence: 99%

Determinants of Weight Evolution Among HIV-Positive Patients Initiating Antiretroviral Treatment in Low-Resource Settings

Veld

Balestre

Buyze

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background In resource limited settings clinical parameters, including body weight changes, are used to monitor clinical response. Therefore we studied body weight changes in patients on antiretroviral treatment (ART) in different regions of the world. Methods Data were extracted from the “International Epidemiologic Databases to Evaluate AIDS”, a network of ART programmes that prospectively collects routine clinical data. Adults on ART from the Southern-, East-, West- and Central African and the Asia-Pacific regions were selected from the database if baseline data on body weight, gender, ART regimen and CD4 count were available. Body weight change over the first two years and the probability of body weight loss in the second year were modelled using linear mixed models and logistic regression respectively. Results Data from 205,571 patients were analysed. Mean adjusted body weight change in the first 12 months was higher in patients started on tenofovir and/or efavirenz; in patients from Central, West and East Africa, in men, and in patients with a poorer clinical status. In the second year of ART it was greater in patients initiated on tenofovir and/or nevirapine, and for patients not on stavudine, in women, in Southern Africa and in patients with a better clinical status at initiation. Stavudine in the initial regimen was associated with a lower mean adjusted body weight change and with weight loss in the second treatment year. Conclusion Different ART regimens have different effects on body weight change. Body weight loss after one year of treatment in patients on stavudine might be associated with lipoatrophy.

show abstract

“…This likely represents a strong correlation between ART adherence and fat redistribution syndrome, contrary to a previous report from Rwanda. 57 The use of d4T was also associated with VF at baseline when compared to TDF (most commonly used), ZDV, ABC, and ddI. The ART regimen only had a trend towards significance when more variables were included in the model.…”

Section: Discussionmentioning

confidence: 92%

Early Warning Indicators for First-Line Virologic Failure Independent of Adherence Measures in a South African Urban Clinic

Marconi

Hampton

et al. 2013

AIDS Patient Care and STDs

View full text Add to dashboard Cite

We sought to develop individual-level Early Warning Indicators (EWI) of virologic failure (VF) for clinicians to use during routine care complementing WHO population-level EWI. A case-control study was conducted at a Durban clinic. Patients after ‡ 5 months of first-line antiretroviral therapy (ART) were defined as cases if they had VF [HIV-1 viral load (VL) > 1000 copies/mL] and controls (2:1) if they had VL £ 1000 copies/mL. Pharmacy refills and pill counts were used as adherence measures. Participants responded to a questionnaire including validated psychosocial and symptom scales. Data were also collected from the medical record. Multivariable logistic regression models of VF included factors associated with VF ( p < 0.05) in univariable analyses. We enrolled 158 cases and 300 controls. In the final multivariable model, male gender, not having an active religious faith, practicing unsafe sex, having a family member with HIV, not being pleased with the clinic experience, symptoms of depression, fatigue, or rash, low CD4 counts, family recommending HIV care, and using a TV/radio as ART reminders (compared to mobile phones) were associated with VF independent of adherence measures. In this setting, we identified several key individual-level EWI associated with VF including novel psychosocial factors independent of adherence measures.

show abstract

Weight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, Rwanda

Cited by 17 publications

References 24 publications

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Correlation between the immuno-virological response and the nutritional profile of treatment-experienced HIV-infected patients in the East region of Cameroon

Determinants of Weight Evolution Among HIV-Positive Patients Initiating Antiretroviral Treatment in Low-Resource Settings

Early Warning Indicators for First-Line Virologic Failure Independent of Adherence Measures in a South African Urban Clinic

Contact Info

Product

Resources

About