2025/09/05 by Berihun Bantie1*, Natnael Atnafu Gebeyehu2
paper · doi:10.20372/nadre:17264
Nutritional status is considered a major diagnostic and prognostic indicator of HIV/AIDS in adults. In<br> this aspect, current HIV-treatment guidelines, particularly in low-income countries, recommend the<br> regular monitoring of body mass index (BMI) to determine patients’ clinical response to antiretroviral<br> therapy (ART). However, data regarding the change in BMI status of HIV-positive adults on ART<br> following the implementation of the test and treat strategy were limited in Ethiopia. Hence, this<br> study is aimed at investigating the trends of BMI change over time and its associated factors among<br> HIV-positive adults in Northwest Ethiopia. A retrospective longitudinal study was conducted among<br> 404 randomly selected HIV-positive adults receiving ART in Felegehiwot Comprehensive Specialized<br> Hospital (FHCSH), Northern Ethiopia. Data were extracted from the medical record charts of study<br> participants, entered into Epi-data 4.6 software, and exported to Stata 14.2 software for analysis. A<br> generalized estimating equation (GEE) model was fitted to determine the change in BMI status over<br> time and its predictors in HIV-positive adults. The level of significance was declared at a p-value of<br> < 0.05. More than half (201, or 51.73%) of the total 404 participants were female. In the cohort, both<br> the baseline and follow-up mean body mass index levels of the participants fell in the normal range<br> and increased from 20.34 (standard deviation/SD ± 2.8) to 21.41 (SD ± 3.13). The individual profile plots<br> of 50 participants indicated that there is considerable variability in weight change across individuals.<br> Duration of ART follow-up (β = 0.203, 95% confidence interval (CI) 0.16 to 0.24), unemployment<br> (β = - 0.96, 95% CI 1.67 to - 0.25), WHO stage III/IV HIV disease (β = - 0.92, 95% CI - 1.57 to - 0.35),and<br> Tenofovir/Lamivudine/Dolutegravir (TDF/3TC/DTG)ART regimen (β = 0.95, 95% CI 0.32 to 1.57)<br> were identified as significant predictors of change in the BMI status of participants. Likewise, the<br> interaction of TDF/3TC/DTG ART regimen * follow-up duration (β = 2.16, 95% CI 1.84 to 2.84), WHO<br> stage III/IV clinical disease * follow-up duration (β = - 1.43, 95% CI - 1.71 to - 1.15) and TB/HIV<br> co-infection * follow-up duration (β = 1.89, 95% CI 1.57 to 2.87) significantly affects the trend in BMI<br> change status of HIV-positive adults. In this study, the BMI status of HIV-positive adults receiving ART<br> increased with a linear trend. Unemployment, stage III/IV HIV diseases, and Tenofovir/Lamivudine/<br> Efavirenz (TDF/3TC/EFV) ART-drug regimen decreases the mean BMI status of HIV-positive adults.<br> Special consideration and strict follow-up need to be given to those individuals with advanced HIV/<br> AIDS diseases and other identified risk group.