Overweight in early HIV predicts slower disease progression in HIV+ Adults in Botswana

Objective To determine the predictive value of higher BMI on HIV disease progression in asymptomatic, ART naïve HIV+ adults. Methods After consenting 218 participants, blood was drawn for measures of HIV disease progression (CD4 cell count, CD4 cell % and HIV viral load) at baseline and every 6 months for 24 months. Height, and weight were obtained and BMI calculated. BMI was categorized as underweight (<18.5 kg/m 2 ), normal weight (18.5–24.9 kg/m 2 ), overweight (25.0–29.9 kg/m 2 ), and obese (>30 kg/m 2 ). Results The mean age was 34.21±8.33 years, 76.04% were female and the mean CD4 cell count was 468.26±161.21 cells/μL. The mean BMI was 24.07±4.64 kg/m 2 . The prevalence of overweight and obesity was 26.42% (N=56) and 9.91% (N=21), respectively, similar to that in the general population of Botswana. Using mixed models, higher levels of BMI were predictive of higher levels of CD4 cell % over time after controlling for age (β=0.914, p=0.001). BMI category 25–29.9 kg/m 2 was significantly predictive of lower HIV viral load log10 over time (β= −0.145, p=0.0295) after controlling for age and gender. Conclusions In this HIV+ ART naïve cohort, being overweight predicted a slower HIV disease progression. Mechanistic studies on the relationship between higher BMI and HIV disease progression are needed to support recommendations for HIV care in developing countries. Funded by NIDA