Malnutrition and immune dysfunction in patients infected with human immunodeficiency virus.
OBJECTIVE
To determine forms of malnutrition and basal metabolism at different stages of immunological impairment in clinically stable patients infected with Human Immunodeficiency Virus (HIV).


METHODS
Cross sectional study.


METHODS
53 outpatients with HIV-infection classified according to the Walter Reed staging system (WR1 to WR6).


RESULTS
87% of the patients showed some evidence of malnutrition. Reduced body weight was found in 53%, 68% and 25% had decreases in fat and body cell mass, 17% had visceral protein deficiency, whereas extracellular mass and serum triglyceride concentrations were increased in 58% and 30%, respectively. Reduced serum albumin and transferrin closely paralleled immunological depression, whereas alterations in body composition were manifest early during HIV-infection (WR3) and remained unchanged during the transition to the Acquired Immune Deficiency Syndrome itself. Resting metabolic rate increased from WR1 to WR3; it remained within the expected range during later stages (WR4-WR6), but was not appropriately reduced in response to the loss in body cell mass.


CONCLUSIONS
HIV-infected patients display both, calorie and protein malnutrition. Immunological depression was independent of loss of body mass, but was closely associated to decreases in serum albumin values. Nutritional assessment and intervention should therefore be performed at an early stage of HIV-infection.
Süttmann
U
U
Medizinische Hochschule Hannover, Zentrum Innere Medizin, Hannover, FRG.
Müller
M J
MJ
Ockenga
J
J
Hoogestraat
L
L
Coldewey
R
R
Schedel
I
I
Deicher
H
H
D000328:Adult; D003430:Cross-Sectional Studies; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D007136:Immunoglobulins / Q000378:metabolism; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D009894:Opportunistic Infections / Q000276:immunology; D011502:Protein-Energy Malnutrition / Q000276:immunology*; D016176:T-Lymphocyte Subsets / Q000276:immunology
D007136:Immunoglobulins