Body Mass Index and CD4+ T-Lymphocyte Recovery in HIV-Infected Men with Viral Suppression on Antiretroviral Therapy

PURPOSE: To better characterize the relationship between body mass index (BMI) and CD4+ T-lymphocyte recovery in HIV disease. METHODS: We analyzed the association between baseline BMI and CD4+ T-lymphocyte increases, as well as the association between BMI and immune activation (CD38 and HLA-DR co-expression on CD4+ and CD8+ T-lymphocytes), in male HIV-infected patients who achieved viral suppression on antiretroviral therapy (ART). RESULTS: Baseline BMI predicted change in CD4+ T-lymphocyte count at weeks 96 ( P = .03, n = 461) and 144 ( P = .005, n = 357) but not at week 48 ( P = .38, n = 558). Relative to men with a normal BMI, overweight and obese men had increases at week 144 that were 35 and 113 cells/ mm3 higher, respectively, while underweight men had CD4+ T-lymphocyte increases that were 94 cells/mm3 lower. No significant correlations between baseline BMI and cellular immune activation were seen. CONCLUSIONS: BMI predicts CD4+ T-lymphocyte gains in men started on ART.