In HIV, Obesity Is Associated With Neurological Decline
An older individual with HIV and obesity is at greater risk of worsening neurocognitive function over time compared with someone with a normal body mass index (BMI), according to a new study presented at the Conference on Retroviruses and Opportunistic Infections.
Study author Dr Kristine M. Erlandson, from University of Colorado in Aurora, presented her team’s findings on March 7.
It is well known that neurocognition can decline with older age among individuals with HIV. Yet, it is unclear which factors are directly related to the decline in this patient population. To assess this, the researchers evaluated annual assessments for neurocognitive impairment among 929 individuals who received antiretroviral treatment for HIV.
The researchers defined obesity as a BMI greater than 30 kg/m²; overweight as a BMI of 25 to 30 kg/m²; and normal weight as a BMI of 18.5 to 25 kg/m2.
Among all the participants, 81% were men, 31% were black, and 20% were Hispanic. A majority of participants (92%) had undetectable plasma HIV RNA, with a median CD4 count of 631 cells/mm³ at the start of the study.
At baseline, 16% of participants had neurocognitive impairment, 29% had obesity, and 40% were overweight. Over 3 years, 6% of participants developed neurocognitive impairment, whereas 78% remained unimpaired.
Multivariable analyses showed that increasing age, obesity, and overweight BMI compared with a normal BMI were associated with increasing prevalence of neurocognitive impairment compared with those unimpaired.
“These results extend previous work demonstrating a higher risk of neurocognitive impairment among obese people living with HIV by showing that obese individuals are also at greater risk of subsequently transitioning from unimpaired to impaired neurocognition,” the researchers concluded.
—Melinda Stevens
Reference:
Perez J, Andrade A, Ellis RJ, et al. Obesity is independently associated with neurocognitive decline in HIV. Paper presented at: Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle, WA. http://www.croiconference.org/sessions/obesity-independently-associated-neurocognitive-decline-hiv. Accessed March 8, 2019.