BACKGROUND: In developing countries, access to laboratory tests remains limited, and the use of simple tools such as weight to monitor HIV-infected patients treated with
antiretroviral therapy should be evaluated. METHODS:
Cohort study of 2451 Cambodian and 2618 Kenyan adults who initiated
antiretroviral therapy between 2001 and 2007. The
prognostic value of weight
gain at 3 months of
antiretroviral therapy on 3-6 months mortality, and at 6 months on 6-12 months mortality, was investigated using
Poisson regression. RESULTS:
Mortality rates [95%
confidence interval (CI)] between 3 and 6 months of
antiretroviral therapy were 9.9 (7.6-12.7) and 13.5 (11.0-16.7) per 100 person-years in Cambodia and Kenya, respectively. At 3 months, among patients with initial
body mass index less than or equal to 18.5 kg/m (43% of the
study population),
mortality rate ratios (95% CI) were 6.3 (3.0-13.1) and 3.4 (1.4-8.3) for those with weight
gain less than or equal to 5 and 5-10%, respectively, compared with those with weight
gain of more than 10%. At 6 months, weight
gain was also predictive of subsequent mortality:
mortality rate ratio (95% CI) was 7.3 (4.0-13.3) for those with weight
gain less than or equal to 5% compared with those with weight
gain of more than 10%. CONCLUSION: Weight
gain at 3 months is strongly associated with survival. Poor compliance or undiagnosed
opportunistic infections should be investigated in patients with initial
body mass index less than or equal to 18.5 and achieving weight
gain less than or equal to 10%.
