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Open Access Publications from the University of California

Body Mass Index and Cognitive Function among HIV-1 Infected Individuals in China, India and Nigeria.

  • Author(s): Jumare, Jibreel
  • El-Kamary, Samer S
  • Magder, Laurence
  • Hungerford, Laura
  • Umlauf, Anya
  • Franklin, Donald
  • Ghate, Manisha
  • Abimiku, Alash'le
  • Charurat, Man
  • Letendre, Scott
  • Ellis, Ronald J
  • Mehendale, Sanjay
  • Blattner, William A
  • Royal, Walter
  • Marcotte, Thomas D
  • Heaton, Robert K
  • Grant, Igor
  • McCutchan, J Allen
  • et al.

BACKGROUND:Risk of cognitive impairment is increased among persons with high or low body mass index (BMI) in HIV- and HIV+ populations in resource-rich settings. We examined this association among HIV+ patients in three resource-limited settings. METHODS:This secondary analysis included data of 761 HIV+ volunteers pooled from 3 prospective cohort studies conducted in China (n=404; 53%25), India (n=200; 26%25) and Nigeria (n=157; 21%25). World Health Organization (WHO) weight classifications were based on BMI. T scores, adjusted for demographics and practice effects, were derived from a 7-domain neuropsychological battery. Neurocognitive impairment (NCI) was defined as global deficit score (GDS) of ≥ 0.5. RESULTS:Overall prevalence of NCI at baseline was 27.7%25 (similar across all cohorts). The overweight/obese and underweight constituted 37.3%25 and 15.5%25 of the total participants respectively. In a multivariable logistic regression of pooled longitudinal data, adjusting for clinical and demographic variables, the odds of global neurocognitive impairment were 38%25 higher among the overweight/obese as compared to normal weight participants (OR: 1.38 [95%25 CI: 1.1, 1.72]; P=0.005). Similarly, the odds of global neurocognitive impairment were 39%25 higher among the underweight as compared to normal weight participants (OR: 1.39 [95%25 CI: 1.03, 1.87]; P=0.029). CONCLUSION:Neurocognitive impairment among HIV-1 infected patients was more prevalent in both overweight/obese and underweight than normal weight individuals in three resource-limited settings, confirming observations in resource rich settings. Mechanisms underlying these associations are unclear, but likely differ for underweight and overweight persons.

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