Body composition changes in patients with human immunodeficiency virus infection

Area of Science:

• Biomedical Science
• Nutritional Science
• Infectious Disease Research

Background:

• Malnutrition, characterized by weight loss and wasting, is common in advanced human immunodeficiency virus (HIV) infection, progressing to Acquired Immunodeficiency Syndrome (AIDS).
• Early signs of malnutrition in HIV-infected patients without weight loss may manifest as an increased ratio of extracellular mass (ECM) to body cell mass (BCM).

Purpose of the Study:

• To evaluate body composition changes in HIV-infected patients using bioelectrical impedance analysis (BIA).
• To assess the utility of the ECM/BCM ratio as an early indicator of malnutrition in HIV-infected individuals.

Main Methods:

• Body composition measurements were obtained at baseline and after 6 weeks in 18 HIV-infected patients (CD4 counts 140-740 cells/mm³).
• Bioelectrical impedance was used to measure body compartments, calculating the ECM/BCM ratio.
• Body Mass Index (BMI) was correlated with ECM/BCM ratio and ECM.

Main Results:

• The average ECM/BCM ratio was within the normal range (0.77 +/- 0.13 vs. normal 0.83 +/- 0.16), suggesting no overt malnutrition by this criterion at baseline.
• BCM (kg) measurements were largely within normal ranges, with some exceeding normal values.
• A significant correlation was found between BMI and the ECM/BCM ratio (r²=0.38, P=0.00) and ECM (r²=0.244, P=0.003), indicating overweight patients might be misclassified as malnourished.

Conclusions:

• Bioelectrical impedance analysis may detect subtle nutritional changes in HIV-infected patients before significant weight loss.
• The ECM/BCM ratio may become more reflective of malnutrition once significant weight loss and BCM decrease occur.
• BIA is a potentially useful tool for evaluating malnutrition in HIV-infected populations, warranting prospective evaluation.