Elevated resting energy expenditure among HIV-seropositive persons receiving highly active antiretroviral therapy.
OBJECTIVE
To ascertain the relationships between resting energy expenditure (REE), HIV RNA in plasma, and highly active antiretroviral therapy (HAART).


METHODS
Cross-sectional analysis using data of a large cohort study of nutrition in relation to HIV disease.


METHODS
HIV RNA in plasma, REE, fat-free mass (FFM), and medication regimens were assessed at 530 visits among 372 participants in a cohort study of HIV-seropositive men and women.


RESULTS
HIV RNA in plasma was directly correlated with REE. After adjustment for FFM, age, CD4 cell count and HAART use, there was an increase in REE of 90 kJ/day per log10 copies/ml increase in HIV RNA [95% confidence interval (CI) 16-164; P = 0.02). HAART use had an independent effect on REE. In patients reporting HAART use, adjusted REE was 339 kJ/day higher than in those not reporting HAART use (95% CI 177-501; P = 0.0001).


CONCLUSIONS
Viral load and HAART appear to exert independent effects on REE. Although HAART may decrease metabolic rate by lowering viral burden, it appears to increase metabolic demands through some mechanism(s) independent of its effect on viral burden. This may result in elevated REE despite control of viral replication.
Shevitz
A H
AH
Department of Family Medicine and Community Health, Tufts University School of Medicine, Boston, Massachusetts, USA.
Knox
T A
TA
Spiegelman
D
D
Roubenoff
R
R
Gorbach
S L
SL
Skolnik
P R
PR
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001481:Basal Metabolism / Q000187:drug effects; D001823:Body Composition; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D006678:HIV / Q000235:genetics / Q000502:physiology; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism* / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D019562:Viral Load; D014779:Virus Replication
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors