Body composition of HIV-positive patients with pulmonary tuberculosis: a cross-sectional study in Mwanza, Tanzania.
To estimate the weight deficit and body composition of cases of pulmonary TB (PTB), and assess the roles of HIV and the acute-phase response, a cross-sectional study was carried out in Tanzania. Weight, body mass index (BMI), arm muscle area (AMA), arm fat area (AFA) and the serum concentration of the acute-phase protein alpha(1)-antichymotrypsin (serum ACT) were evaluated for each of 532 cases of PTB and 150 'non-TB' controls. On average, the female cases of PTB not only weighed 7.8 kg less but also had BMI that were 3.1-kg/m(2) lower, AMA that were 14.8-cm(2) lower, and AFA that were 7.6-cm(2) lower than those seen in the female subjects without TB. Similarly, on average, the male cases of PTB weighed 7.1 kg less and had BMI that were 2.5-kg/m(2) lower, AMA that were 18.8-cm(2) lower and AFA that were 1.6-cm(2) lower than those seen in the male subjects without TB. Although HIV infection was associated with a 1.7-kg lower weight and a 0.6-kg/m(2) lower BMI (with deficits in both AMA and AFA) among males, it was not associated with any such deficits among the female subjects. Elevated serum ACT was found to be a negative predictor of BMI, AMA and AFA, partially explaining the effects of the PTB but not those of the HIV. There is need for a better understanding of the determinants and effects of loss of fat and lean body mass in HIV-positive tuberculosis.
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National Institute for Medical Research, Muhimbili Medical Research Centre, P.O. Box 3436, Dar es Salaam, Tanzania.
Malenganisho
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W
Temu
M M
MM
Changalucha
J
J
Magnussen
P
P
Krarup
H
H
Andersen
A B
AB
Friis
H
H
D000210:Acute-Phase Reaction / Q000097:blood; D000293:Adolescent; D000328:Adult; D001823:Body Composition; D001837:Body Weights and Measures; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV / Q000276:immunology*; D006679:HIV Seropositivity / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D016014:Linear Models; D008297:Male; D011247:Pregnancy; D017678:Sex Distribution; D013183:Sputum / Q000382:microbiology; D013636:Tanzania / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D000514:alpha 1-Antichymotrypsin / Q000097:blood*
D000514:alpha 1-Antichymotrypsin