Body shape and composition in HIV-infected women: an urban cohort.
OBJECTIVE
Alterations in body shape and composition are associated with HIV/AIDS. Wasting remains prevalent; increasingly, lipodystrophy is reported. Obesity is also epidemic in the USA. In this study, we sought to characterize the body changes reported by women attending a US urban clinic, and to evaluate contributing factors using inexpensive methods that are readily available in clinical practice.


METHODS
In an urban Maryland clinic, a cross-section of HIV-infected women were evaluated by self report, anthropomorphic measurements, bioelectric impedance analysis (BIA) and chart review; they were categorized as no change, lipodystrophy, weight loss/wasting or weight gain/obesity.


RESULTS
One hundred and sixty-one women were evaluated: 144 (89%) were African-American; 100 (62%) had used intravenous drugs and 40 (25%) were actively injecting drugs, while 39 (24%) smoked crack. Ninety-five (59%) were on highly active antiretroviral therapy (HAART) for a median period of 11.7 months [interquartile range (IQR)=4.5-24.2]. Since starting current HAART or in the previous year, 12 (7.4%) reported lipodystrophy changes, 85 (52.8%) weight gain, 27 (16.8%) overall weight loss, and 37 (23.0%) no change. Lipodystrophy was associated with higher CD4 percentage (P=0.03), lower frequency of crack use (P=0.04) and higher educational level (P=0.03). Weight loss correlated with longer duration of infection (P=0.01), select BIA results and increased rate of crack use (P=0.005). Weight gain was associated with higher fat mass (P=0.005), higher peak viral load (P=0.02), and lower rate of intravenous drug use (P=0.03).


CONCLUSIONS
Self-reported changes in body shape were common. Obesity and complications of illicit drug use were more prevalent than lipodystrophy in this inner-city population of HIV-positive women.
Karmon
S L
SL
Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Moore
R D
RD
Dobs
A S
AS
Keruly
J
J
Barnett
S
S
Cofrancesco
J
J
D000273:Adipose Tissue / Q000502:physiology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004522:Educational Status; D017097:Electric Impedance; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000503:physiopathology; D006801:Humans; D013997:Time Factors; D014504:Urban Health; D019562:Viral Load