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Body composition in clinically stable men with HIV infection
1Clinical Therapeutics Laboratory, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
Insights
Individuals with advanced HIV disease experience significant loss of both muscle and fat, even with adequate calorie intake. This body composition change is linked to lower CD4+ T cell counts, indicating disease severity.
Area of Science:
- Immunology
- Infectious Diseases
- Human Physiology
Background:
- Human immunodeficiency virus (HIV) infection can lead to significant changes in body composition.
- Understanding these changes is crucial for managing patient health and treatment efficacy.
- Previous studies have indicated potential links between HIV disease severity and altered body composition.
Purpose of the Study:
- To investigate the relationship between HIV disease severity, indicated by CD4+ T cell counts, and body composition in clinically stable, HIV-infected men.
- To assess differences in body fat, muscle mass, and visceral protein stores across varying stages of HIV infection.
Main Methods:
- Recruitment of 106 clinically stable HIV-infected men on antiretroviral therapy.
- Categorization of subjects into three groups based on CD4+ T cell counts: <200, 200-600, and >600 cells/mm³.
- Assessment of body composition using standard measures, serum markers of visceral protein, and kilocalorie intake.
Main Results:
- Subjects with advanced HIV disease (CD4+ T cells < 200) exhibited significantly lower body fat compared to those with higher CD4+ counts (200-600 and >600).
- No significant difference in body fat was observed between the two higher CD4+ count groups.
- The entire cohort displayed significantly reduced muscle mass when compared to established norms.
Conclusions:
- Advanced HIV disease is associated with substantial reductions in both muscle mass and body fat.
- These body composition changes occur independently of adequate kilocalorie intake, suggesting a direct impact of HIV on metabolic processes.
- The findings highlight the need for monitoring and addressing body composition in HIV-infected individuals, particularly those with lower CD4+ T cell counts.
Abstract:
Clinically stable HIV-infected men (N = 106) receiving investigational antiretrovirals were recruited. Subjects were divided into three HIV disease severity groups by CD4+ cell count. Standard measures of body composition were assessed, as well as serum measures of visceral protein stores and kilocalorie intake. Group 1 subjects (CD4+ T cells < 200) had significantly lower measures of body fat as compared with Group 2 (CD4 between 200 and 600) and Group 3 (CD4 > 600) despite adequate kilocalorie intake. Group 2 and Group 3 were not significantly different from each other. Our entire cohort had significantly lower muscle mass compared to norms. Our data demonstrate that people with advanced HIV disease have reduced muscle and fat.