Lilian Ogochukwu Ezechi
Federal College of Education (Technical)
Lillian is a trained Nutritionist with basic degree in human nutrition and a Master degree in Nutritional Biochemistry. She is currently a lecturer at the department of Home economics, Federal College of Education (Technical) Lagos Nigeria.
The introduction and improved access to antiretroviral therapy has changed the once deadly infection to a chronic medical condition, resulting in a dramatic change in causes of morbidity and mortality among HIV infected individuals. Obesity and its cardiovascular sequel are increasingly been reported in literature. However, data on the burden, trends and risk factors for obesity are sparse in countries worse hit by the epidemic. The objective of the study was to investigate the trend and risk factors for obesity among a cohort of HIV infected adults on antiretroviral therapy.We evaluated prospectively collected data in an ongoing observational study at the HIV treatment centre, Nigerian Institute of Medical Research, Lagos. Patients that initiated treatment between January 2004 and December 2009, and completed 5 year follow up were included in the analysis. Multivariate analysis was used to determine the risk factors for obesity among the cohort. Of the 8819 patients, 15.8% were wasted, 12.7% underweight, 19.6% overweight and 7.4% were obese at baseline. After five years follow up, only 2.3 % and 3.6% respectively were wasted and underweight. 35.7% and 26.5% respectively were overweight and obese. Female gender (aOR: 2.2; 95% CI: 1.81-2.67) and having a CD4 count above 350 (aOR: 2.51; 95% CI: 2.13 – 3.09) were found to be independent risk factors for obesity at multivariate analysis. Type of ARV drug, age, marital status, viral load, and haemoglobin levels did not retain their independent association with obesity after controlling for confounding variables. Obesity is highly prevalent among HIV infected Nigerians on antiretroviral therapy and is associated with female gender and high CD4 count. Programme targeted at prevention of obesity and its sequel should be integrated into routine HIV care.
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