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Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study

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Harvard

Achhra, AC, Mocroft, A, Reiss, P, Sabin, C, Nielsen, LR, de Wit, S, Smith, CJ, d'Arminio Monforte, A, Phillips, A, Weber, R, Lundgren, J, Law, MG & D:A:D Study Group 2016, 'Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study' HIV Medicine, vol. 17, no. 4, pp. 255-68. https://doi.org/10.1111/hiv.12294

APA

Achhra, A. C., Mocroft, A., Reiss, P., Sabin, C., Nielsen, L. R., de Wit, S., ... D:A:D Study Group (2016). Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study. HIV Medicine, 17(4), 255-68. https://doi.org/10.1111/hiv.12294

CBE

Achhra AC, Mocroft A, Reiss P, Sabin C, Nielsen LR, de Wit S, Smith CJ, d'Arminio Monforte A, Phillips A, Weber R, Lundgren J, Law MG, D:A:D Study Group. 2016. Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study. HIV Medicine. 17(4):255-68. https://doi.org/10.1111/hiv.12294

MLA

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Author

Achhra, A C ; Mocroft, A ; Reiss, P ; Sabin, C ; Nielsen, Lene Ryom ; de Wit, S ; Smith, C J ; d'Arminio Monforte, A ; Phillips, A ; Weber, R ; Lundgren, J ; Law, M G ; D:A:D Study Group. / Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes : the D:A:D study. In: HIV Medicine. 2016 ; Vol. 17, No. 4. pp. 255-68.

Bibtex

@article{43184a8d96614de0ae04b8825af7b283,
title = "Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes: the D:A:D study",
abstract = "OBJECTIVES: The aim of the study was to assess the impact of the gain in body mass index (BMI) observed immediately after antiretroviral therapy (ART) initiation on the subsequent risk of cardiovascular disease (CVD) and diabetes.METHODS: We analysed data from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort study. Outcomes were development of (i) CVD (composite of myocardial infarction/stroke/coronary procedure) and (ii) diabetes. The main exposure variable was change in BMI from ART initiation (pre-ART) to 1 year after initiation (continuous variable) in treatment-na{\"i}ve individuals initiating ART with no history of CVD or diabetes (for respective outcomes). BMI [weight (kg)/(height (m))(2) ] was categorized as underweight (< 18.5), normal (18.5-25), overweight (25-30) and obese (> 30). Poisson regression models were fitted stratified for each pre-ART BMI category to allow for category-specific estimates of incidence rate ratio (IRR). Models were adjusted for pre-ART BMI and CD4 count, key known risk factors (time-updated where possible) and calendar year.RESULTS: A total of 97 CVD events occurred in 43 982 person-years (n = 9321) and 125 diabetes events in 43 278 person-years (n = 9193). In fully adjusted analyses for CVD, the IRR/unit gain in BMI (95{\%} confidence interval) in the first year of ART, by pre-ART BMI category, was: underweight, 0.90 (0.60-1.37); normal, 1.18 (1.05-1.33); overweight, 0.87 (0.70-1.10), and obese, 0.95 (0.71-1.28) (P for interaction = 0.04). For diabetes, the IRR/unit gain in BMI was 1.11 (95{\%} confidence interval 1.03 to 1.21), regardless of pre-ART BMI (P for interaction > 0.05).CONCLUSIONS: Short-term gain in BMI following ART initiation appeared to increase the longer term risk of CVD, but only in those with pre-ART BMI in the normal range. It was also associated with increased risk of diabetes regardless of pre-ART BMI.",
author = "Achhra, {A C} and A Mocroft and P Reiss and C Sabin and Nielsen, {Lene Ryom} and {de Wit}, S and Smith, {C J} and {d'Arminio Monforte}, A and A Phillips and R Weber and J Lundgren and Law, {M G} and {D:A:D Study Group}",
note = "{\circledC} 2015 British HIV Association.",
year = "2016",
doi = "10.1111/hiv.12294",
language = "English",
volume = "17",
pages = "255--68",
journal = "HIV Medicine",
issn = "1464-2662",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "4",

}

RIS

TY - JOUR

T1 - Short-term weight gain after antiretroviral therapy initiation and subsequent risk of cardiovascular disease and diabetes

T2 - the D:A:D study

AU - Achhra, A C

AU - Mocroft, A

AU - Reiss, P

AU - Sabin, C

AU - Nielsen, Lene Ryom

AU - de Wit, S

AU - Smith, C J

AU - d'Arminio Monforte, A

AU - Phillips, A

AU - Weber, R

AU - Lundgren, J

AU - Law, M G

AU - D:A:D Study Group

N1 - © 2015 British HIV Association.

PY - 2016

Y1 - 2016

N2 - OBJECTIVES: The aim of the study was to assess the impact of the gain in body mass index (BMI) observed immediately after antiretroviral therapy (ART) initiation on the subsequent risk of cardiovascular disease (CVD) and diabetes.METHODS: We analysed data from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort study. Outcomes were development of (i) CVD (composite of myocardial infarction/stroke/coronary procedure) and (ii) diabetes. The main exposure variable was change in BMI from ART initiation (pre-ART) to 1 year after initiation (continuous variable) in treatment-naïve individuals initiating ART with no history of CVD or diabetes (for respective outcomes). BMI [weight (kg)/(height (m))(2) ] was categorized as underweight (< 18.5), normal (18.5-25), overweight (25-30) and obese (> 30). Poisson regression models were fitted stratified for each pre-ART BMI category to allow for category-specific estimates of incidence rate ratio (IRR). Models were adjusted for pre-ART BMI and CD4 count, key known risk factors (time-updated where possible) and calendar year.RESULTS: A total of 97 CVD events occurred in 43 982 person-years (n = 9321) and 125 diabetes events in 43 278 person-years (n = 9193). In fully adjusted analyses for CVD, the IRR/unit gain in BMI (95% confidence interval) in the first year of ART, by pre-ART BMI category, was: underweight, 0.90 (0.60-1.37); normal, 1.18 (1.05-1.33); overweight, 0.87 (0.70-1.10), and obese, 0.95 (0.71-1.28) (P for interaction = 0.04). For diabetes, the IRR/unit gain in BMI was 1.11 (95% confidence interval 1.03 to 1.21), regardless of pre-ART BMI (P for interaction > 0.05).CONCLUSIONS: Short-term gain in BMI following ART initiation appeared to increase the longer term risk of CVD, but only in those with pre-ART BMI in the normal range. It was also associated with increased risk of diabetes regardless of pre-ART BMI.

AB - OBJECTIVES: The aim of the study was to assess the impact of the gain in body mass index (BMI) observed immediately after antiretroviral therapy (ART) initiation on the subsequent risk of cardiovascular disease (CVD) and diabetes.METHODS: We analysed data from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort study. Outcomes were development of (i) CVD (composite of myocardial infarction/stroke/coronary procedure) and (ii) diabetes. The main exposure variable was change in BMI from ART initiation (pre-ART) to 1 year after initiation (continuous variable) in treatment-naïve individuals initiating ART with no history of CVD or diabetes (for respective outcomes). BMI [weight (kg)/(height (m))(2) ] was categorized as underweight (< 18.5), normal (18.5-25), overweight (25-30) and obese (> 30). Poisson regression models were fitted stratified for each pre-ART BMI category to allow for category-specific estimates of incidence rate ratio (IRR). Models were adjusted for pre-ART BMI and CD4 count, key known risk factors (time-updated where possible) and calendar year.RESULTS: A total of 97 CVD events occurred in 43 982 person-years (n = 9321) and 125 diabetes events in 43 278 person-years (n = 9193). In fully adjusted analyses for CVD, the IRR/unit gain in BMI (95% confidence interval) in the first year of ART, by pre-ART BMI category, was: underweight, 0.90 (0.60-1.37); normal, 1.18 (1.05-1.33); overweight, 0.87 (0.70-1.10), and obese, 0.95 (0.71-1.28) (P for interaction = 0.04). For diabetes, the IRR/unit gain in BMI was 1.11 (95% confidence interval 1.03 to 1.21), regardless of pre-ART BMI (P for interaction > 0.05).CONCLUSIONS: Short-term gain in BMI following ART initiation appeared to increase the longer term risk of CVD, but only in those with pre-ART BMI in the normal range. It was also associated with increased risk of diabetes regardless of pre-ART BMI.

U2 - 10.1111/hiv.12294

DO - 10.1111/hiv.12294

M3 - Journal article

VL - 17

SP - 255

EP - 268

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 4

ER -

ID: 45586590