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Observational Study
. 2016 Nov 28;30(18):2805-2813.
doi: 10.1097/QAD.0000000000001248.

Long-term body composition changes in antiretroviral-treated HIV-infected individuals

Philip M Grant  1 , Douglas Kitch, Grace A McComsey, Ann C Collier, Benedetta Bartali, Susan L Koletar, Kristine M Erlandson, Jordan E Lake, Michael T Yin, Kathy Melbourne, Belinda Ha, Todd T Brown
Affiliations
Observational Study

Long-term body composition changes in antiretroviral-treated HIV-infected individuals

Philip M Grant et al. AIDS. .

Abstract

Objective: Body composition impacts physical function and mortality. We compared long-term body composition changes after antiretroviral therapy (ART) initiation in HIV-infected individuals to that in HIV-uninfected controls.

Design: Prospective observational study.

Methods: We performed dual-energy x-ray absorptiometry (DXA) approximately 7.5 years after initial DXA in available HIV-infected individuals who received DXAs during the randomized treatment trial AIDS Clinical Trials Group A5202. For controls, we used DXA results from HIV-uninfected participants in the Boston Area Community Health/Bone and Women's Interagency HIV Study cohorts. Repeated measures analyses compared adjusted body composition changes between HIV-infected and HIV-uninfected individuals. Multivariable analyses evaluated factors associated with body composition change in HIV-infected individuals.

Results: We obtained DXA results in 97 HIV-infected and 614 HIV-uninfected participants. Compared with controls, HIV-infected individuals had greater adjusted lean mass and total, trunk, and limb fat gain during the first 96 weeks of ART. Subsequently, HIV-infected individuals lost lean mass compared with controls. Total, trunk, and limb fat gains after 96 weeks of ART slowed in HIV-infected individuals but remained greater than in controls. Lower CD4 T-cell count was associated with lean mass and fat gain during the initial 96 weeks of ART, but subsequently no HIV-related characteristic was associated with body composition change.

Conclusion: Consistent with a 'return to health effect', HIV-infected individuals, especially those with lower baseline CD4 T-cell counts, gained more lean mass and fat during the first 96 weeks of ART than HIV-uninfected individuals. Continued fat gain and lean mass loss after 96 weeks may predispose HIV-infected individuals to obesity-related diseases and physical function impairment.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTERESTS D.K and B.B. have no relevant disclosures.

Figures

Figure 1
Figure 1
a: Change in Lean Mass by Serostatus (in kilograms) b: Change in Total Fat by Serostatus (in kilograms) c: Change in Trunk Fat by Serostatus (in kilograms) d: Change in Limb Fat by Serostatus (in kilograms)
Figure 1
Figure 1
a: Change in Lean Mass by Serostatus (in kilograms) b: Change in Total Fat by Serostatus (in kilograms) c: Change in Trunk Fat by Serostatus (in kilograms) d: Change in Limb Fat by Serostatus (in kilograms)
Figure 1
Figure 1
a: Change in Lean Mass by Serostatus (in kilograms) b: Change in Total Fat by Serostatus (in kilograms) c: Change in Trunk Fat by Serostatus (in kilograms) d: Change in Limb Fat by Serostatus (in kilograms)
Figure 1
Figure 1
a: Change in Lean Mass by Serostatus (in kilograms) b: Change in Total Fat by Serostatus (in kilograms) c: Change in Trunk Fat by Serostatus (in kilograms) d: Change in Limb Fat by Serostatus (in kilograms)
See this image and copyright information in PMC

References

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