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Body shape and composition in HIV‐infected women: an urban cohort
Author(s) -
Karmon SL,
Moore RD,
Dobs AS,
Keruly J,
Barnett S,
Cofrancesco J
Publication year - 2005
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2005.00284.x
Subject(s) - lipodystrophy , medicine , wasting , interquartile range , weight gain , cohort , weight loss , antiretroviral therapy , obesity , human immunodeficiency virus (hiv) , cohort study , body weight , viral load , immunology
Objectives Alterations in body shape and composition are associated with HIV/AIDS. Wasting remains prevalent; increasingly, lipodystrophy is reported. Obesity is also epidemic in the USA. In this study, we sought to characterize the body changes reported by women attending a US urban clinic, and to evaluate contributing factors using inexpensive methods that are readily available in clinical practice. Methods In an urban Maryland clinic, a cross‐section of HIV‐infected women were evaluated by self report, anthropomorphic measurements, bioelectric impedance analysis (BIA) and chart review; they were categorized as no change, lipodystrophy, weight loss/wasting or weight gain/obesity. Results One hundred and sixty‐one women were evaluated: 144 (89%) were African‐American; 100 (62%) had used intravenous drugs and 40 (25%) were actively injecting drugs, while 39 (24%) smoked crack. Ninety‐five (59%) were on highly active antiretroviral therapy (HAART) for a median period of 11.7 months [interquartile range (IQR)=4.5–24.2]. Since starting current HAART or in the previous year, 12 (7.4%) reported lipodystrophy changes, 85 (52.8%) weight gain, 27 (16.8%) overall weight loss, and 37 (23.0%) no change. Lipodystrophy was associated with higher CD4 percentage ( P= 0.03), lower frequency of crack use ( P= 0.04) and higher educational level ( P= 0.03). Weight loss correlated with longer duration of infection ( P= 0.01), select BIA results and increased rate of crack use ( P= 0.005). Weight gain was associated with higher fat mass ( P= 0.005), higher peak viral load ( P= 0.02), and lower rate of intravenous drug use ( P= 0.03). Conclusions Self‐reported changes in body shape were common. Obesity and complications of illicit drug use were more prevalent than lipodystrophy in this inner‐city population of HIV‐positive women.