Bioelectrical impedance analysis in HIV-infected patients treated with triple antiretroviral treatment
Schwenk, A.; Beisenherz, A.; Kremer, G.; Diehl, V.; Salzberger, B.; Fätkenheuer, G.
American Journal of Clinical Nutrition 70(5): 867-873
1999
ISSN/ISBN: 0002-9165 PMID: 10539747 Document Number: 533911
The effect of triple antiretroviral treatment on body composition and on the prevalence of malnutrition was assessed. Two cross-sectional studies, 1 in 1996 (t96; n=247) and 1 in 1997 (t97; n=266), were conducted in HIV-infected outpatients. Among patients who participated in both studies, 111 patients started a new antiretroviral treatment including a proteinase inhibitor (PI) between t96 and t97 and were studied longitudinally. Total body water (TBW), intracellular water (ICW), extracellular water (ECW) and fat mass were estimated by monofrequency bioelectrical impedance analysis (BIA). Prevalence of malnutrition was reduced by 30-50% from t96 to t97, depending on the definition used. In the longitudinal study, TBW and the ratio of ICW:ECW increased and fat mass decreased (P<0.001). BIA indicated a greater increase in ICW in 23 (21%) patients with clinically apparent fat redistribution than in patients without this syndrome, but estimates of fat mass changes were not significantly different. It is concluded that triple antiretroviral treatment may protect HIV-infected patients against the development of malnutrition. Whole-body BIA data suggest an increase in appendicular body cell mass associated with improved antiretroviral treatment. However, the method is unreliable in detecting fat redistribution, and current prediction equations will need to be recalibrated for HIV-infected patients receiving highly active antiretroviral treatment.