Body mass index and risk of tuberculosis and death
- 19 June 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in AIDS
- Vol. 24 (10), 1501-1508
- https://doi.org/10.1097/qad.0b013e32833a2a4a
Abstract
Background: High BMI has been shown to be protective against tuberculosis (TB) among HIV-uninfected individuals, as well as against disease progression and mortality among those with HIV. We examined the effect of BMI on all-cause mortality and TB incidence among a cohort of HIV-infected adults in Soweto, South Africa. Methods: A clinical cohort of 3456 HIV-infected adults from South Africa was prospectively followed from 2003 to 2008 with regular monitoring. The primary exposure was BMI and the outcomes of interest were all-cause mortality and a newly diagnosed episode of TB. Cox proportional hazard models assessed associations with risk of mortality or incident TB. Results: Incidence rates of mortality were 10.4/100 person-years for baseline BMI of 18.5 or less, 3.6/100 person-years for baseline BMI 18.6–25, 1.7/100 person-years for baseline BMI 25.1–30, and 1.6/100 person-years for baseline BMI more than 30. Compared to those with normal BMI, overweight and obese participants had a significantly reduced risk of mortality [adjusted hazard ratio 0.59 (95% confidence interval, CI 0.40–0.87) and 0.48 (95% CI 0.29–0.80), respectively]. Incidence rates of TB by baseline BMI were 7.3/100 person-years for underweight, 6.0/100 person-years for normal, 3.2/100 person-years for overweight, and 1.9/100 person-years for obese. Compared to those with normal BMI, those with overweight and obese BMI were at a significantly reduced risk of developing TB [adjusted hazard ratio 0.56 (95% CI 0.38–0.83) and 0.33 (95% CI 0.19–0.55), respectively]. Conclusion: HIV-infected individuals with obese and overweight BMI have a significantly reduced risk of both mortality and TB, after adjusting for HAART use and CD4 cell count.Keywords
This publication has 30 references indexed in Scilit:
- Vitamin D and tuberculosisPublished by Oxford University Press (OUP) ,2009
- Incidence and determinants of mortality and morbidity following early antiretroviral therapy initiation in HIV-infected adults in West AfricaAIDS, 2007
- Hiding in the shadows of the HIV epidemic: obesity and hypertension in a rural population with very high HIV prevalence in South AfricaJournal of Human Hypertension, 2007
- Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of MalawiAIDS, 2006
- Overweight and Human Immunodeficiency Virus (HIV) Progression in Women: Associations HIV Disease Progression and Changes in Body Mass Index in Women in the HIV Epidemiology Research Study CohortClinical Infectious Diseases, 2003
- Triple Trouble: the Role of Malnutrition in Tuberculosis and Human Immunodeficiency Virus Co-infectionPublished by Oxford University Press (OUP) ,2003
- Nutrition and HIV infectionBritish Journal of Nutrition, 2002
- Prevalence and Predictive Value of Overweight in an Urban HIV Care ClinicJAIDS Journal of Acquired Immune Deficiency Syndromes, 2001
- Nutritional Alterations Associated With HIV InfectionJAIDS Journal of Acquired Immune Deficiency Syndromes, 2000
- When Obesity Is Desirable: A Longitudinal Study of the Miami HIV-1–Infected Drug Abusers (MIDAS) CohortJAIDS Journal of Acquired Immune Deficiency Syndromes, 2000