title: Sex differences in the associations of HIV disease characteristics and body composition in antiretroviral-naive persons.
abstract: 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.
authors.affiliation: Baylor College of Medicine and Houston AIDS Research Team, Houston, TX, USA. fehmidav@bcm.tmc.edu
authors.forename: Fehmida
authors.initials: F
authors.lastname: Visnegarwala
authors.forename: Subhasree S
authors.initials: SS
authors.lastname: Raghavan
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Mullin
authors.forename: Glenn
authors.initials: G
authors.lastname: Bartsch
authors.forename: Jack
authors.initials: J
authors.lastname: Wang
authors.forename: Donald
authors.initials: D
authors.lastname: Kotler
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Gibert
authors.forename: Judith
authors.initials: J
authors.lastname: Shlay
authors.forename: Carl
authors.initials: C
authors.lastname: Grunfeld
authors.forename: Andrew
authors.initials: A
authors.lastname: Carr
authors.forename: Wafaa
authors.initials: W
authors.lastname: El-Sadr
mesh_terms: 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
chemical_list: D012367:RNA, Viral