BODY MASS INDEX AND CD4 COUNT IN PATIENTS UNDERGOING HIGHLY ACTIVE ANTIRETROVIRAL TREATMENT AT THE BAMENDA REGIONAL HOSPITAL, CAMEROON

Main Article Content

DONFACK JEAN HUBERT
NSALAR MELVIN MESEKA
ATEMKENG TSATEDEM FAUSTIN
NGUEGUIM TSOFACK FLORENCE
DEMANOU MAURICE

Abstract

Background: The long-term effect of highly active antiretroviral treatment (HAART) has caused weight gain among HIV-infected individuals, leading to an increased prevalence of overweight and obesity. Increased Body Mass Index (BMI) has been associated with adverse health outcome in non-HIV and HIV populations.

Aim of the Study: To evaluate the relationship between BMI, and CD4 count among HIV infected subjects undergoing treatment with HAART.

Methodology: This was a cross-sectional retrospective study involving 205 HIV-infected adults receiving antiretroviral therapy (ART) from the Day Hospital of the Bamenda Regional Hospital (BRH). Past medical records were used to gather demographic, clinical and anthropometric information dating from August 2014 to September 2015. Records for CD4 counts were taken at 2 instances (first and second CD4 count) per patient after a strict interval of 6 months. Data was analysed using EPI Info version 3.5.1 and Excel 2007. Descriptive and inferential statistical analyses were used to measure proportions and associations respectively.

Results: Of the 205 subjects, 69.8 % (n = 143) were women and 30.2 % (n = 62) were men. Subjects were aged from 22 - 72 years. The prevalence of the weight categories were: obese (21.5 %), overweight (35.1 %), normal weight (42.4 %) and underweight (1 %). Women had significantly higher CD4 counts than men (P = 0.05 and P = 0.002 respectively). BMI was positively associated with CD4 count (P = 0.002). Normal weight was a protective factor for the outcome of a CD4 decrease (OR = 0.5033 95 % CI 0.29-0.89).

Conclusion: This study demonstrated that there was a direct and significant association between CD4 count and BMI in HIV-infected persons. However more research is needed to prove the credibility of obesity, as a protective factor for HIV infected person especially.

Keywords:
Human immunodeficiency virus, body mass index, antiretroviral, CD4 counts, Bamenda Regional Hospital

Article Details

How to Cite
HUBERT, D. J., MESEKA, N. M., FAUSTIN, A. T., FLORENCE, N. T., & MAURICE, D. (2022). BODY MASS INDEX AND CD4 COUNT IN PATIENTS UNDERGOING HIGHLY ACTIVE ANTIRETROVIRAL TREATMENT AT THE BAMENDA REGIONAL HOSPITAL, CAMEROON. Journal of International Research in Medical and Pharmaceutical Sciences, 17(2), 1-10. https://doi.org/10.56557/jirmeps/2022/v17i27844
Section
Original Research Article

References

Voundi EV, Kalla GCM, Kenfack JDT, Olen JPK, Essi MJ, Mbopi-Keou FX. Association entre dépression et charge virale chez les personnes sous traitement antirétroviral suivies à l´ Hôpital Central de Yaoundé au Cameroun. The Pan African Medical Journal. 2022;41.

Doitsh G, Greene WC. Dissecting how CD4 T cells are lost during HIV infection. Cell Host & Microbe. 2016;19(3):280-291.

Sattentau QJ, Moore JP. x The role of CD4 in HIV binding and entry. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences. 2016; 342(1299):59-66.

Endres MJ, Clapham PR, Marsh M, Ahuja M, Turner JD, McKnight A, Hoxie JA. CD4-independent infection by HIV-2 is mediated by fusin/CXCR4. Cell. 1996;87(4):745-756.

Serrano‐Villar S, Moreno S, Fuentes‐Ferrer M, Sánchez‐Marcos C, Avila M, Sainz T, Estrada V. The CD 4: CD 8 ratio is associated with markers of age‐associated disease in virally suppressed HIV‐infected patients with immunological recovery. HIV Medicine. 2014;1:5(1):40-49.

Bodhade AS, Ganvir SM, Hazarey VK. Oral manifestations of HIV infection and their correlation with CD4 count. Journal of Oral Science. 2011;53(2):203-211.

Cohen MS, McCauley M, Gamble TR. HIV treatment as prevention and HPTN 052. Current Opinion in HIV and AIDS. 2012;7(2):99.

Burns DN, Dieffenbach CW, Vermund SH. Rethinking prevention of HIV type 1 infection. Clinical Infectious Diseases. 2010;51(6):725-731.

Granich R, Crowley S, Vitoria M, Lo YR, Souteyrand Y, Dye C, Williams B. Highly active antiretroviral treatment for the prevention of HIV transmission. Journal of the International AIDS Society. 2010; 13(1):1-8.

Cohen MS, Fidler S. HIV prevention 2010: where are we now and where are we going?. Current Opinion in HIV and AIDS. 2010;5(4):265-268.

Granich R, Crowley S, Vitoria M, Smyth C, Kahn JG, Bennett R, Williams B. Highly active antiretroviral treatment as prevention of HIV transmission: review of scientific evidence and update. Current Opinion in HIV and AIDS. 2010;5(4):298.

Montaner JS, Hogg R, Wood E, Kerr T, Tyndall M, Levy AR, Harrigan PR. The case for expanding access to highly active antiretroviral therapy to curb the growth of the HIV epidemic. The Lancet. 2006; 368(9534):531-536.

Smith K, Powers KA, Kashuba AD, Cohen MS. HIV-1 treatment as prevention: the good, the bad, and the challenges. Current Opinion in HIV and AIDS. 2011;6(4):315.

Ambrosioni J, Calmy A, Hirschel B. HIV treatment for prevention. Journal of the International AIDS Society. 2011;14(1):1-8.

Cohen MS, Gay CL. Treatment to prevent transmission of HIV-1. Clinical Infectious Diseases. 2010; 50(Supplement_3):S85-S95.

Hawkins T. Understanding and managing the adverse effects of antiretroviral therapy. Antiviral Research. 2010;85(1):201-209.

Trotta MP, Ammassari A, Melzi S, Zaccarelli M, Ladisa N, Sighinolfi L, Antinori A. Treatment-related factors and highly active antiretroviral therapy adherence. Journal of Acquired Immune Deficiency Syndromes. 2002;1999:31, S128-31.

Hartmann M. The side effects of antiretroviral therapy. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, Und verwandte Gebiete. 2006;57(11):969-974.

Magnani R, MacIntyre K, Karim AM, Brown L, Hutchinson P, Kaufman C, Transitions Study Team. The impact of life skills education on adolescent sexual risk behaviors in KwaZulu-Natal, South Africa. Journal of adolescent Health. 2005;36(4):289-304.

Ferrulli A. Obesity: Classification and Diagnosis. In Thyroid, Obesity and Metabolism (pp. 73-93). Springer, Cham; 2021.

Sandie AB, Tchatchueng Mbougua JB, Nlend AEN, Thiam S, Nono BF, Fall NA, Faye CM. Hot-spots of HIV infection in Cameroon: a spatial analysis based on Demographic and Health Surveys data. BMC Infectious Diseases. 2022;22(1):1-11.

De Beaudrap P, Beninguisse G, Pasquier E, Tchoumkeu A, Touko A, Essomba F, Mont D. Prevalence of HIV infection among people with disabilities: a population-based observational study in Yaoundé, Cameroon (HandiVIH). The Lancet HIV. 2017;4(4):e161-e168.

Crum-Cianflone N, Tejidor R, Medina S, Barahona I, Ganesan A. Obesity among patients with HIV: the latest epidemic. AIDS patient care and STDs. 2008 ;22(12):925-930.

Blashill AJ, Mayer KH, Crane HM, Baker JS, Willig JH, Willig AL, Safren SA. Body mass index, depression, and condom use among HIV-infected men who have sex with men: a longitudinal moderation analysis. Archives of Sexual Behavior. 2014 ;43(4):729-734.

Ho CF, Lee SS, Wong KH, Cheng LS, Lam MY. Setting a minimum threshold CD4 count for initiation of highly active antiretroviral therapy in HIV‐infected patients. HIV Medicine. 2007;8(3):181-185.

Mahajan AP, Hogan JW, Snyder B, Kumarasamy N, Mehta K, Solomon S, Flanigan TP. Changes in total lymphocyte count as a surrogate for changes in CD4 count following initiation of HAART: implications for monitoring in resource-limited settings. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2004;36(1):567-575.

Mocroft A, Phillips AN, Gatell J, Ledergerber B, Fisher M, Clumeck N, Euro SIDA study group. Normalisation of CD4 counts in patients with HIV-1 infection and maximum virological suppression who are taking combination antiretroviral therapy: an observational cohort study. The Lancet. 2007; 370(9585):407-413.

Hunt PW, Deeks SG, Rodriguez B, Valdez H, Shade SB, Abrams DI, Martin JN. Continued CD4 cell count increases in HIV-infected adults experiencing 4 years of viral suppression on antiretroviral therapy. Aids. 2003;17(13):1907-1915.

Montarroyos UR, Miranda-Filho DB, César CC, Souza WV, Lacerda HR, Militão Albuquerque MDFP, Ximenes RADA. Factors related to changes in CD4+ T-cell counts over time in patients living with HIV/AIDS: a multilevel analysis. PloS one. 2014;9(2):e84276.

Quach LA, Wanke CA, Schmid CH, Gorbach SL, Mwamburi DM, Mayer KH, Tang AM. Drug use and other risk factors related to lower body mass index among HIV-infected individuals. Drug and Alcohol Dependence. 2008;95(1-2):30-36.

Jones CY, Hogan JW, Snyder B, Klein RS, Rompalo A, Schuman P, HIV Epidemiology Research Study Group. 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 cohort. Clinical Infectious Diseases. 2003;37(Supplement2):S69-S80.

Crum-Cianflone NF, Roediger M, Eberly LE, Vyas K, Landrum ML, Ganesan A, Agan BK. Obesity among HIV-infected persons: impact of weight on CD4 cell count. AIDS (London, England). 2010; 24(7):1069.

Paz-Filho G, Mastronardi C, Franco CB, Wang KB, Wong ML, Licinio J. Leptin: molecular mechanisms, systemic pro-inflammatory effects, and clinical implications. Arquivos Brasileiros de Endocrinologia & Metabologia. 2012;56:597-607.

Fernández-Riejos P, Najib S, Santos-Alvarez J, Martín-Romero C, Pérez-Pérez A, González-Yanes C, Sánchez-Margalet V. Role of leptin in the activation of immune cells. Mediators of Inflammation; 2010.

Otero M, Lago R, Gomez R, Dieguez C, Lago F, Gomez-Reino J, Gualillo O. Towards a pro-inflammatory and immunomodulatory emerging role of leptin. Rheumatology. 2006; 45(8):944-950.

Papathanassoglou E, El-Haschimi K, Li XC, Matarese G, Strom T, Mantzoros C. Leptin receptor expression and signaling in lymphocytes: kinetics during lymphocyte activation, role in lymphocyte survival, and response to high fat diet in mice. The Journal of Immunology. 2006;176(12):7745-7752.

Busso N, So A, Chobaz-Péclat V, Morard C, Martinez-Soria E, Talabot-Ayer D, Gabay C. Leptin signaling deficiency impairs humoral and cellular immune responses and attenuates experimental arthritis. The Journal of Immunology. 2002;168(2):875- 882.