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CROI 2013: Obesity in HIV

Obesity is a strong risk factor for many of the co-morbidities that are now common in HIV-infected individuals, including CVD, diabetes, hypertension, and cancer. Using the Medical Management Project in 2009, CDC investigators reported on rates of obesity in the HIV-infected population [1]. Data on the general population derived from the NHANES survey. Compared to the general population, the age adjusted prevalence of obesity (BMI >30 kg/m2) in HIV was lower overall (35.7% v. 22.8%), and in men (36% v.17%), but higher in women (36% v. 40%).

Weight gain is commonly seen after initiation of ART. Even though obesity is not more prevalent in HIV-infected men than in the general population, weight gain may carry more ominous health implications. Herrin et al. [2] analyzed the large VACS database to ascertain the effect of weight gain on risk of incident diabetes. At baseline they found only 10% of HIV-positives in the VACS database were obese compared to 36% in HIV-negatives. After one year, the HIV-positive group was more likely to experience a weight gain of >5 lbs. In multivariable analysis adjusted for baseline characteristics, every 5 lbs of weight gain conferred a 10% increase in risk of incident diabetes after 5 years of follow-up, compared with 6% in the HIV-negative population.

These study show obesity is prevalent in HIV, especially in women, and the weight gain associated with ART appears to carry an amplified risk of diabetes. Because multiple other risk factors for these conditions are often present, strong efforts to achieve ideal body weight and smoking cessation are needed in management of HIV-infected individuals.


1. Thompson-Paul A, Wei S, Mattson C, Skarbinski J. Prevalence of Obesity in a Nationally Representative Sample of HIV+ Adults Receiving Medical Care in the US: Medical Monitoring Project, 2009. Presented March 5, 2013 at the 20th CROI, Atlanta Georgia. Poster Abstract 777;

2. Herrin M, Tate J, M Freiberg M, et al. Risk of Incident Diabetes Associated with Weight Gain after cART Initiation. Presented March 4, 2013 at the 20th CROI, Atlanta Georgia. PosterAbstract 804;

Source: Reporting for PRN News: David H. Shepp, MD