Antiretroviral Clinical Trials – Breaking News

A Randomized, Controlled Trial of a Behavioral Weight Loss Program for HIV-Infected Patients
Becofsky K et al.
Clin Infect Dis. 2017 Apr 1;64(7):967-970

26th July 2017, by Dr Anton Pozniak

Obesity compounds the negative health effects of HIV infection. We conducted the first randomized trial of behavioral weight loss for HIV-infected patients (n = 40).

Methods : Subjects were randomly assigned with a 1:1 allocation, to an Internet-delivered behavioral weight loss (WTLOSS, n=20)) or Internet-delivered education (CONTROL, n=20) program. The WTLOSS program is a 12-week behavioral program delivered via the Internet, which includes 12 weekly interactive multimedia lessons that teach behavioral strategies for changing diet and exercise behaviors to promote weight loss. The program prescribes a low-calorie, low-fat diet (1200–1800 kcal per day, with <30% of kcal from fat) and gradual increases in physical activity using primarily brisk walking. Participants self-monitor their weight, intake, and physical activity, and submit this information to the study website; they receive a weekly automated message providing feedback. The CONTROL group had a weekly educational lesson posted on the study website to provide basic information about healthy eating, exercise, and weight loss. No behavioral strategies for changing diet and exercise were presented.

Results : At baseline, the groups were similar on most measures, except CONTROL participants were older (mean age 53.6 vs 46.3, p = 0.01) and had higher baseline CD4 cell counts (866 vs 619/mm 3 , p =0 .02) than WTLOSS. ART regimen repartition, co-morbidities and co-medications were similar in both groups.
Participants randomized to an Internet behavioral weight loss program had greater 12-week weight loss (mean, 4.4 ± 5.4 kg vs 1.0 ± 3.3 kg; p = 0.021) and improvements in quality of life than controls (p = 0.046).

Conclusion : this study suggests that an Internet-delivered behavioral weight loss program may be an effective approach to promoting weight loss in people living with HIV. Given that weight loss provides an actionable approach to comorbidities associated with HIV infection and obesity, further research on the efficacy of behavioral weight loss interventions for changing both weight and improving health in this population is clearly needed.

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