Long-term body composition changes in antiretroviral-treated HIV-infected individuals

被引：71

作者：

Grant, Philip M. ^{[1
]}

Kitch, Douglas ^{[2
]}

McComsey, Grace A. ^{[3
,4
]}

Collier, Ann C. ^{[5
]}

Bartali, Benedetta ^{[6
]}

Koletar, Susan L. ^{[7
]}

Erlandson, Kristine M. ^{[8
]}

Lake, Jordan E. ^{[9
]}

Yin, Michael T. ^{[10
]}

Melbourne, Kathy ^{[11
]}

Ha, Belinda ^{[12
]}

Brown, Todd T. ^{[13
]}

机构：

[1] Stanford Univ, Dept Med, Div Infect Dis, Palo Alto, CA 94304 USA

[2] Harvard TH Chan Sch Publ Hlth, Ctr Biostat AIDS Res, Boston, MA USA

[3] Case Western Reserve Univ, Dept Pediat, Div Infect Dis, Cleveland, OH 44106 USA

[4] Case Western Reserve Univ, Dept Med, Div Infect Dis, Cleveland, OH 44106 USA

[5] Univ Washington, Dept Med, Div Infect Dis, Seattle, WA USA

[6] New England Res Inst, 9 Galen St, Watertown, MA 02172 USA

[7] Ohio State Univ, Dept Med, Div Infect Dis, Columbus, OH 43210 USA

[8] Univ Colorado, Div Infect Dis, Dept Med, Aurora, CO USA

[9] Univ Calif Los Angeles, Dept Med, Div Infect Dis, Los Angeles, CA 90024 USA

[10] Columbia Univ, Dept Med, Div Infect Dis, New York, NY USA

[11] Gilead Sci, Foster City, CA USA

[12] Viiv Healthcare, Res Triangle Pk, NC USA

[13] Johns Hopkins Univ, Dept Med, Div Endocrinol Diabet & Metab, Baltimore, MD USA

来源：

AIDS | 2016年 / 30卷 / 18期

关键词：

anti-HIV agents/*administration & dosage/*adverse effects; body fat distribution; HIV infection; HIV infections/*drug therapy/virology; HIV-associated lipodystrophy syndrome/*chemically induced; humans; BONE-MINERAL DENSITY; PROTEASE INHIBITORS; RANDOMIZED-TRIAL; FRAILTY; MUSCLE; ASSOCIATION; RALTEGRAVIR; REGIMENS; THERAPY; ADULTS;

D O I：

10.1097/QAD.0000000000001248

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

071005 [微生物学]; 100108 [医学免疫学];

摘要：

Objective: Body composition impacts physical function and mortality. We compared long-term body composition changes after antiretroviral therapy (ART) initiation in HIV-infected individuals to that in HIV-uninfected controls. Design: Prospective observational study. Methods: We performed dual-energy x-ray absorptiometry (DXA) approximately 7.5 years after initial DXA in available HIV-infected individuals who received DXAs during the randomized treatment trial AIDS Clinical Trials Group A5202. For controls, we used DXA results from HIV-uninfected participants in the Boston Area Community Health/Bone and Women's Interagency HIV Study cohorts. Repeated measures analyses compared adjusted body composition changes between HIV-infected and HIV-uninfected individuals. Multivariable analyses evaluated factors associated with body composition change in HIV-infected individuals. Results: We obtained DXA results in 97 HIV-infected and 614 HIV-uninfected participants. Compared with controls, HIV-infected individuals had greater adjusted lean mass and total, trunk, and limb fat gain during the first 96 weeks of ART. Subsequently, HIV-infected individuals lost lean mass compared with controls. Total, trunk, and limb fat gains after 96 weeks of ART slowed in HIV-infected individuals but remained greater than in controls. Lower CD4(+) T-cell count was associated with lean mass and fat gain during the initial 96 weeks of ART, but subsequently no HIV-related characteristic was associated with body composition change. Conclusion: Consistent with a 'return to health effect', HIV-infected individuals, especially those with lower baseline CD4(+) T-cell counts, gained more lean mass and fat during the first 96 weeks of ART than HIV-uninfected individuals. Continued fat gain and lean mass loss after 96 weeks may predispose HIV-infected individuals to obesity-related diseases and physical function impairment. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

引用

页码：2805 / 2813

页数：9

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