Prevalence and predictive value of overweight in an urban HIV care clinic

Objective: To determine the prevalence and predictive value of overweight in an urban HIV clinic. Methods: Medical records of all new adult, nonpregnant registrants in 1996 in an urban HIV clinic with at least one height and weight measurement were reviewed. Body mass index (BMI) at clinic enrollment was calculated, and prevalence of overweight was thus determined. The subsequent clinical course of the overweight group was compared with that of a randomly selected group of gender-stratified non-overweight patients. Results: At baseline, 12.6% of men and 32.5% of women were overweight. Female gender and lack of AIDS diagnosis were independently associated with overweight. More than one half of women and 19.6% of men were overweight at some point during the study. Providers were more likely to properly acknowledge underweight than overweight. Among patients without AIDS, there was a trend toward slower disease progression and lower viral load in overweight patients, despite similar baseline CD4⁺ lymphocyte counts and similar time to initiation of highly active antiretroviral therapy. In multivariate proportional hazards analyses, lower baseline BMI and falling BMI during follow-up were independently predictive of progression to AIDS. Conclusions: Overweight was a common and underrecognized finding, particularly among women. Overweight patients may progress more slowly to AIDS than non-overweight patients.