Weight and body shape changes in a treatment-naive population after 6 months of nevirapine-based generic highly active antiretroviral therapy in South India.
BACKGROUND
The nutritional and body shape response after the initiation of highly active antiretroviral therapy (HAART) in resource-limited environments has not been documented. In this environment, nutritional compromise is a common complication of human immunodeficiency virus (HIV) infection.


METHODS
We conducted a prospective study of 190 HIV-infected patients who initiated a nevirapine-based HAART regimen. CD4+ T cell count, body weight, body mass index, anthropometry, and bioelectrical impedance data were collected prior to initiation of therapy and after 6 months of therapy.


RESULTS
The mean age of participants was 35 years, 85% of participants were male, and 59% received stavudine as 1 of the nucleosides in their initial HAART regimen. The members of the cohort were malnourished before the initiation of therapy and had a mean body mass index of 20.1 (calculated as weight in kilograms divided by the square of height in meters). Overall, body weight increased a mean of 2.8 kg (range, -12.5 to 22.5 kg), and CD4+ T cell counts increased by a mean of 140 cells/mm3. Patients were stratified into those who lost weight (loss of >1 kg, 22%; n=41), those whose weight remained stable (19%; n=37), and those who gained weight (gain of >1 kg, 59%; n=112). Patients in all groups retained body shape symmetry and experienced no change in waist-to-hip ratio or regional body shape by anthropometry.


CONCLUSIONS
The group that lost weight and the group whose weight remained stable experienced significant CD4+ T cell count increases at 6 months. Although the majority of HIV-infected patients who received nevirapine-based HAART gained weight, there were participants who lost weight despite initiating their first HAART therapy.
Saghayam
Suneeta
S
YR Gaitonde Centre for AIDS Research and Education, Chennai, 600 113, India. suneeta@yrgcare.org
Kumarasamy
N
N
Cecelia
Anitha J
AJ
Solomon
Suniti
S
Mayer
Kenneth
K
Wanke
Christine
C
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001823:Body Composition; D001835:Body Weight / Q000187:drug effects*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D019829:Nevirapine / Q000009:adverse effects* / Q000627:therapeutic use*; D018119:Stavudine / Q000009:adverse effects / Q000627:therapeutic use; D015215:Zidovudine / Q000009:adverse effects / Q000627:therapeutic use
D019380:Anti-HIV Agents; D019259:Lamivudine; D015215:Zidovudine; D019829:Nevirapine; D018119:Stavudine