title: Severity of human immunodeficiency virus infection is associated with decreased phase angle, fat mass and body cell mass in adults with pulmonary tuberculosis infection in Uganda.
abstract: Although coinfection with tuberculosis and human immunodeficiency virus (HIV) is emerging as a major problem in many developing countries, nutritional status has not been well characterized in adults with tuberculosis and HIV infection. We compared nutritional status between 261 HIV-positive and 278 HIV-negative adults with pulmonary tuberculosis in Kampala, Uganda, using anthropometry and bioelectrical impedance analysis. Among 163 HIV-positive and 199 HIV-negative men, intracellular water-to-extracellular water (ICW:ECW) ratio was 1.48 +/- 0.26 and 1.59 +/- 0.48 (P = 0.006) and phase angle was 5.42 +/- 1.05 and 5.76 +/- 1.30 (P = 0.009), respectively. Among 98 HIV-positive and 79 HIV-negative women, ICW:ECW was 1.19 +/- 0.16 and 1.23 +/- 0.15 (P = 0.11) and phase angle was 5.35 +/- 1.27 and 5.43 +/- 0.93 (P = 0.61), respectively. There were no significant differences in BMI, body cell mass, fat mass or fat-free mass between HIV-positive and HIV-negative adults. Among HIV-positive subjects, BMI, ICW:ECW, body cell mass, fat mass and phase angle were significantly lower among those with CD4(+) lymphocytes < or = 200 cells/microL compared with those who had > 200 cells/microL. In sub-Saharan Africa, coinfection with pulmonary tuberculosis and HIV is associated with smaller body cell mass and intracellular water, but not fat-free mass, and by large differences in ICW:ECW and phase angle alpha.
authors.affiliation: The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Shah
authors.forename: C
authors.initials: C
authors.lastname: Whalen
authors.forename: D P
authors.initials: DP
authors.lastname: Kotler
authors.forename: H
authors.initials: H
authors.lastname: Mayanja
authors.forename: A
authors.initials: A
authors.lastname: Namale
authors.forename: G
authors.initials: G
authors.lastname: Melikian
authors.forename: R
authors.initials: R
authors.lastname: Mugerwa
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000378:metabolism*; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D017097:Electric Impedance; D005260:Female; D015658:HIV Infections / Q000145:classification* / Q000378:metabolism; D006801:Humans; D008297:Male; D009752:Nutritional Status; D012720:Severity of Illness Index; D014397:Tuberculosis, Pulmonary / Q000378:metabolism*; D014454:Uganda