Weight changes among antiretroviral therapy-naïve people living with human immunodeficiency virus in Lagos, Nigeria.

Introduction: The advent of antiretroviral therapy (ART) has converted HIV from a death sentence to a chronic disease. Subsequently, weight changes, including the development of overweight/obesity have been observed following ART initiation. Our study aimed to assess weight changes and the associated factors among ART-naïve people living with HIV (PLWH) following enrollment in an ART clinic in Lagos, Nigeria.

Methodology: Data were collected among adult ART-naïve PLWH enrolled at a large ART clinic over 10 consecutive years. Weight changes within the first 6 months of enrolment were determined by actual and relative weight differences expressed in kilogram (kg) and percentages (%) respectively. Weight changes were classified as neutral weight change, weight gain and weight loss. Logistic regressions were applied to identify variables associated with weight changes with statistical significance set at p < 0.05.

Results: A total of 6,737 study participants had their weights available at both visits. Most study participants were females (67.2%), employed (83.3%), married (57.1%), and had normal range body mass index (53.5%). Almost half (49.5%) of the study participants gained weight, while 25.5% recorded weight loss. Baseline variables, including viral load ≥ 100,000 copies/ml, CD4 counts ≤ 200 cells/μL, WHO clinical stages 3 and 4, male gender, presence of anaemia and tuberculosis were associated with weight gain after ART initiation.

Conclusion: Considering the high proportion of participants that gained weight, this study highlights the importance of monitoring weight changes following ART initiation. This will facilitate the identification of PLWH at greater risk for cardiometabolic diseases and other weight-related health outcomes.