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Population-level decline in BMI and systolic blood pressure following mass HIV treatment: Evidence from rural KwaZulu-Natal.

Population-level decline in BMI and systolic blood pressure following mass HIV treatment: Evidence from rural KwaZulu-Natal.
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Geldsetzer P, Feigl AB, Tanser F, Gareta D, Pillay D, Bärnighausen T,


Geldsetzer P, Feigl AB, Tanser F, Gareta D, Pillay D, Bärnighausen T, (click to view)

Geldsetzer P, Feigl AB, Tanser F, Gareta D, Pillay D, Bärnighausen T,

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Obesity (Silver Spring, Md.) 2016 12 07() doi 10.1002/oby.21663
Abstract
OBJECTIVE
Clinic-based studies have shown that patients with human immunodeficiency virus (HIV) gain weight after initiation of antiretroviral therapy (ART). This study aimed to determine whether the scale-up of ART was associated with a population-level increase in body mass index (BMI) and blood pressure (BP) in a community with high HIV and obesity prevalence.

METHODS
A household survey was conducted in rural KwaZulu-Natal before ART scale-up (in 2004) and when ART coverage had reached 25% (in 2010). Anthropometric data was linked with HIV surveillance data.

RESULTS
Mean BMI decreased in women from 29.9 to 29.1 kg/m(2) (P = 0.002) and in men from 24.2 to 23.0 kg/m(2) (P < 0.001). Similarly, overweight and obesity prevalence declined significantly in both sexes. Mean systolic BP decreased from 123.0 to 118.2 mm Hg (P < 0.001) among women and 128.4 to 123.2 mm Hg (P < 0·001) among men. CONCLUSIONS
Large-scale ART provision is likely to have caused a decline in BMI at the population level, because ART has improved the survival of those with substantial HIV-related weight loss. The ART scale-up may have created an unexpected opportunity to sustain population-level weight loss in communities with high HIV and obesity prevalence though targeted lifestyle and nutrition interventions.

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