title: Effect of malabsorption on nutritional status and resting energy expenditure in HIV-infected patients.
abstract: OBJECTIVE
  To assess the influence of malabsorption on nutritional status and energy expenditure in patients at different stages of HIV infection.
  
  
  METHODS
  Fifty HIV patients were classified into three groups: Group 1, HIV asymptomatic patients (n=17); Group 2, AIDS without opportunistic infection (n=16); Group 3, AIDS patients with active infection (n=17). Clinically-healthy subjects (n=19) were used as controls. Parameters measured were: anthropometry, body composition by tetrapolar bioelectrical impedance; resting energy expenditure (REE) by open-circuit indirect calorimetry; malabsoption by D-xylose absorption and triolein breath tests.
  
  
  RESULTS
  Malabsorption (defined as abnormality of xylose and/or fat absorption test) was found in 34 (68%) of patients: 9 (53%) Group 1; 11 (69%) Group 2; 14 (82%) Group 3. Twenty-seven (54%) had sugar malabsorption and 21 (42%) fat malabsorption. A significant relationship was observed between malabsorption and weight loss. REE measured was significantly lower in malabsorptive patients than in non-malabsorptive patients and controls (6006.3+/-846.5 versus 6443.4 + 985.5 versus 6802.1+/-862.7 kJ/day, respectively; P < 0.05). The REE adjusted for fat-free mass was lower in malabsorptive than in non-malabsorptive patients and slightly higher than in controls, although the differences were not statistically significant.
  
  
  CONCLUSIONS
  The results suggest that malabsorption is a frequent feature in HIV infection and is related to the HIV-related weight loss. Hypermetabolism is not a constant phenomenon in HIV infection since, in the presence of malabsorption, our patients show an appropriate metabolic response with a compensatory decrease in REE.
authors.affiliation: Human Nutrition Unit, Faculty of Medicine and Health Sciences, Rovira i Virgili University, Reus, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Jiménez-Expósito
authors.forename: P
authors.initials: P
authors.lastname: García-Lorda
authors.forename: C
authors.initials: C
authors.lastname: Alonso-Villaverde
authors.forename: C M
authors.initials: CM
authors.lastname: de Vírgala
authors.forename: R
authors.initials: R
authors.lastname: Solà
authors.forename: L
authors.initials: L
authors.lastname: Masana
authors.forename: V
authors.initials: V
authors.lastname: Arija
authors.forename: V
authors.initials: V
authors.lastname: Izquierdo
authors.forename: J
authors.initials: J
authors.lastname: Salas-Salvadó
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition; D002151:Calorimetry; D004734:Energy Metabolism; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007408:Intestinal Absorption; D008286:Malabsorption Syndromes / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status