Abstract B140: Multi-class antiretroviral therapy and body mass index in people living with HIV in Puerto Rico: A cross-sectional study

Abstract Background: Antiretroviral therapy (ART) has significantly improved the life expectancy of people living with human immunodeficiency virus (PLWH). However, recent evidence shows an association between long-term ART use and metabolic disturbances like weight gain and higher obesity prevalence. This is important as PLWH are at increased risk of infection-related cancers, while overweight and obesity are established risk factors for at least 13 cancers. We aim to assess the association between the use of multi-class combination ART regimens and behavioral, clinical, and sociodemographic factors with body mass index (BMI) in PLWH in Puerto Rico. Methods: A cross-sectional analysis was conducted using baseline data from the ULACNet-101 study, which recruited PLWH in Puerto Rico (n=596). Participants completed standardized questionnaires collecting behavioral, clinical, and sociodemographic data, including ART regimen information. HIV-related markers included CD4+ T-cell count and viral load. Hypertension was defined as systolic ≥130 or diastolic ≥80 mmHg, based on measurements during visits. The primary exposure was the use of multi-class ART regimens (categorized according to the classification of the ART reported by the participant), and the main outcome was BMI (kg/m2) classified using WHO categories (underweight, normal, overweight, obese). Descriptive statistics summarized key variables. Chi-square tests assessed bivariate associations, and multivariable logistic regression identified predictors of obesity. Results: The mean age was 50.4 years (SD ±12.6), and 70.1% were men. Overall, 78.0% were on multi-class ART; of those, 47.5% reported using the medication for 15 years or more. Additionally, 73.9% had CD4 counts ≥500 cells/µL, and 72.9% had undetectable viral loads (<20 copies/mL). Obesity prevalence was 31.4%, with similar rates in multi-class ART users (31.4%) and non-users (32.6%). In bivariate analyses, obesity was significantly associated with sex, smoking, and hypertension (p<0.05). In multivariable logistic regression, men had lower odds of obesity (OR=0.39; 95% CI: 0.26–0.58) compared to women, while higher odds were observed among participants with hypertension (OR=1.81; 95% CI: 1.15–2.86). No significant association was found between multi-class ART use and obesity. Conclusions: In this cohort of Puerto Rican PLWH, obesity was highly prevalent. Women and individuals with hypertension demonstrated a greater risk of obesity, while no association between multi-class ART use and obesity was found. These findings highlight the importance of incorporating obesity prevention and blood pressure management into HIV care, especially for high-risk subgroups. Citation Format: Cristian D. Velez-Goden, Michael Santiago-Marrero, Frances Vasquez-Sanchez, Jeslie M. Ramos-Cartagena, Josue Perez-Santiago, Jorge Salmeron, Joel Palefsky, Ana P. Ortiz. Multi-class antiretroviral therapy and body mass index in people living with HIV in Puerto Rico: A cross-sectional study [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B140.