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Body composition studies in HIV-infected individuals
1Department of Medicine, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York 10025, USA. dpkotler@aol.com
Annals of the New York Academy of Sciences
|June 24, 2000
Summary
Malnutrition in HIV infection causes significant body cell mass loss. Therapies like anabolic agents and exercise can improve lean mass and quality of life in patients.
Area of Science:
- Nutrition and Metabolism
- Immunology
- Biochemistry
Background:
- Malnutrition is prevalent in HIV infection, characterized by disproportionate loss of body cell mass and expansion of extracellular water.
- Early research indicated depletion of key elements like potassium and nitrogen, alongside skeletal muscle mass loss in HIV-positive individuals.
- The causes of malnutrition influence the specific composition of weight loss, impacting patient outcomes.
Purpose of the Study:
- To review the impact of malnutrition on body composition in HIV infection.
- To explore the effectiveness of various interventions on nutritional status and body composition.
- To highlight current research on body composition changes, including fat redistribution, in patients on highly active antiretroviral therapies.
Main Methods:
- Review of early studies on body composition in HIV.
- Analysis of neutron activation studies for elemental depletion (potassium, nitrogen).
- Inclusion of cross-sectional imaging data for skeletal muscle mass assessment.
- Examination of clinical trial data on nutritional interventions and body composition.
Main Results:
- Malnutrition in HIV leads to significant depletion of body cell mass, lean mass, potassium, and nitrogen.
- Hypercaloric feeding increases weight and body fat but not lean mass.
- Adjunctive therapies (anabolic agents, rhGH, cytokine inhibitors, resistance training) improve fat-free mass, functional performance, and quality of life.
- Highly active antiretroviral therapies are associated with fat redistribution and visceral obesity.
Conclusions:
- Nutritional status is critical for clinical stability in HIV infection.
- Body composition studies are increasingly vital in HIV clinical trials.
- Targeted therapies can effectively improve lean mass and functional outcomes in malnourished HIV patients.
- Fat redistribution and visceral obesity are significant concerns in patients on modern antiretroviral therapy.