title: Effects of HIV and antiretroviral therapy on resting energy expenditure in adult HIV-infected women-a matched, prospective, cross-sectional study.
abstract: BACKGROUND
  Several studies have reported increased resting energy expenditure (REE) in people with human immunodeficiency virus (HIV). However, limited data exist on REE in HIV-infected women and the effect of antiretroviral therapy (ART) on REE in this population.
  
  
  OBJECTIVE
  The purpose of this study was to compare REE in healthy controls to adult HIV-infected women classified in three groups: naïve to ART, on ART with virologic suppression, and on ART with an HIV-1 RNA level >5,000 copies/mL.
  
  
  METHODS
  After a fast, body composition by bioelectrical impedance analysis and REE by indirect calorimetry were determined. Anthropometric measures were also taken.
  
  
  METHODS
  Distributionally appropriate two-sample tests were used for between-group analyses and analysis of covariance was used for confounding adjustment.
  
  
  RESULTS
  Eighty-seven women were enrolled and the HIV-infected and control women were matched for age and body mass index. Log-transformed REE was significantly higher in HIV-infected women naïve to ART compared to controls (7.26±0.22 vs 7.14±0.19; P=0.04, respectively) and the difference remained significant after adjustment for body cell mass (P=0.008). Log-transformed REE was not different in HIV-infected women on ART compared to HIV-infected women naïve to ART (7.25±0.25 vs 7.26±0.23; P=0.81, respectively). Adjusting for body cell mass did not change the results (P=0.56). Similarly, REE was not different between women naïve to ART and those on ART with undetectable HIV-1 RNA, regardless of adjustment for body cell mass. REE correlated to current and nadir CD4 count and trended toward a negative correlation with HIV-1 RNA levels.
  
  
  CONCLUSIONS
  We showed that REE is elevated in ART-naïve, HIV-infected women and continues to be elevated when on ART, regardless of virologic suppression, compared to age and body mass index-matched healthy women. This suggests an effect of HIV infection itself and not ART on REE in these HIV-infected women, and should be considered during nutrition assessment and counseling of HIV-infected adult women.
authors.affiliation: Department of Infectious Diseases, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Mittelsteadt
authors.forename: Corrilynn O
authors.initials: CO
authors.lastname: Hileman
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Harris
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Payne
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Gripshover
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000494:pharmacology*; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000494:pharmacology*; D001481:Basal Metabolism / Q000187:drug effects / Q000502:physiology; D001823:Body Composition; D015992:Body Mass Index; D002153:Calorimetry, Indirect; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D011446:Prospective Studies; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents
keywords: Antiretroviral therapy; Human immunodeficiency virus (HIV); Resting energy expenditure (REE); Women