Sex differences in the associations of HIV disease characteristics and body composition in antiretroviral-naive persons.
BACKGROUND
Data on associations of body composition with HIV disease characteristics are limited.


OBJECTIVE
We compared sex-specific associations between HIV disease characteristics and body composition in an racially-ethnically diverse cohort of antiretroviral-naive patients.


METHODS
The study was a cross-sectional analysis of participants enrolled in a metabolic substudy of a multicenter trial. Regional fat was measured, and total body fat (TBF) was derived by using the Durnin-Womersley formula (DWF) and bioelectrical impedance analysis (BIA). Body cell mass (BCM) was measured by BIA.


RESULTS
Among 422 participants, 22% were women, 60% were African American, and 36% had prior AIDS-defining illnesses. Mean (+/-SD) age was 38.2 +/- 9.6 y, CD4+ count was 215 +/- 184 cells/mm3, and HIV RNA log10 was 5.0 +/- 0.8 copies/mL. On multivariate analysis, women with AIDS-defining illness had significantly (P < 0.005) lower regional body fat and TBF (BIA: -9.5 kg; DWF: -7.3 kg) but nonsignificantly lower BCM (-1.3 kg) than did women without such illnesses, whereas men with AIDS-defining illness had significantly (P < 0.005) lower BCM (-1.7 kg) but nonsignificantly lower TBF (BIA: -1.3 kg; DWF: -1.83 kg) than did men without such illnesses (P < 0.05 for sex differences in TBF). Significant negative associations of HIV RNA with BCM (-0.9 kg/log RNA; P = 0.03), TBF by BIA (-1.4 kg/log RNA; P = 0.05) and by DWF (-1.6 kg/log RNA; P = 0.01), and regional fat were observed in men only.


CONCLUSIONS
The effect of prior AIDS illness on body fat differed significantly between the sexes: women with prior AIDS-defining illness had significantly less fat than did women without such illnesses. An independent effect of HIV viremia on BCM and fat was seen in men. These distinctions may be due to inherent biological differences between the sexes.
Visnegarwala
Fehmida
F
Baylor College of Medicine and Houston AIDS Research Team, Houston, TX, USA. fehmidav@bcm.tmc.edu
Raghavan
Subhasree S
SS
Mullin
Christopher M
CM
Bartsch
Glenn
G
Wang
Jack
J
Kotler
Donald
D
Gibert
Cynthia L
CL
Shlay
Judith
J
Grunfeld
Carl
C
Carr
Andrew
A
El-Sadr
Wafaa
W
D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D000886:Anthropometry; D044383:Black People; D001823:Body Composition; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000276:immunology / Q000503:physiopathology*; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000097:blood; D012737:Sex Factors; D019562:Viral Load; D044465:White People; D001741:Black or African American
D012367:RNA, Viral