Predictors of weight progression among HIV infected adults on anti-retroviral treatment in Mekelle hospital, Tigray, Ethiopia: A longitudinal study

TL;DR

This study examines factors affecting weight changes in HIV patients on treatment in Ethiopia, finding that baseline weight and CD4 levels influence weight progression.

Contribution

The study provides new longitudinal evidence on weight progression predictors for HIV patients in a low-resource setting.

Findings

Patients with normal baseline weight lost more weight than underweight patients at 6 months.

Higher baseline CD4 levels were associated with less weight loss at 24 months.

Weight progression is influenced by both measurement and individual-level factors.

Abstract

Human immunodeficiency virus (HIV) remains a significant global public health issue, causing over 35 million deaths until 2017. In 2013, 24.7 million people in sub-Saharan Africa were living with HIV with 1.5 million new infections and 1.1 million deaths. Evidences on weight progression among HIV patients in low resource settings are limited. Additionally, many of the previously conducted studies were cross-sectional. Therefore, this study aimed to examine predictors of weight progression among adult HIV infected patients on ART from January 2017 to December 2019 in Mekelle hospital, Tigray, Ethiopia.

Retrospective longitudinal study was conducted from March 2, 2020 to March 14, 2020 at Mekelle General Hospital, Tigray, Ethiopia. A total of 97 individuals were followed every six months for two years. STATA version15 was used for data analysis. Linear mixed model was used to examine progression of weight after the baseline measurement. Regression coefficients of the final model and their 95% confidence intervals were used as measures of association with p-value below 0.05 indicating statistical significance.

Baseline median age of participants was found to be 35 years (IQR = 27.5 to 40). At baseline, 39.18% were underweight, 53.61% normal and 7.22% overweight. About one-fifth (19.59%) of the study subjects were diagnosed with tuberculosis infection. Patients who had normal weight at baseline lost 1.89 kg (β = −1.89, 95% CI: −3.11, −0.66) at 6 months compared to underweight patients. Patients with CD4 level of >350 cells/µL at baseline lost 2.53 kg (β = −2.53, 95% CI: −4.43, −0.63) weight lower than patients with CD4 level of <=350 cells/µL, at 24 months.

From this study, it can be concluded that weight of participants is influenced by measurement and individual level factors implying the need to address measurement and individual level factors when dealing with weight progression.

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