Body Mass Index at Time of HIV Diagnosis

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Abstract
Background Identification of basic prognostic indicators of HIV infection is essential before widespread antiretroviral therapy can be implemented in low-technology settings. This study assessed how well body mass index (BMI:kg/m2) predicts survival. Methods BMI within 3 months of HIV diagnosis was obtained from 1657 patients aged ≥15 years, recruited in a seroprevalent clinical cohort in The Gambia since 1992 and followed up at least once. Baseline CD4+ counts and clinical assessment at time of diagnosis were done. Results The mortality hazard ratio (HR) of those with a baseline BMI + cell count (adjusted HR = 2.5, 95% CI 2.0–3.0). Sensitivity and specificity of baseline BMI + count <200 in predicting mortality within 6 months of diagnosis. Discussion BMI at diagnosis is a strong, independent predictor of survival in HIV-infected patients in West Africa. In the absence of sophisticated clinical and laboratory support, BMI may also prove a useful guide for deciding when to initiate antiretroviral therapy.