Weight and body shape changes in a treatment-naive population after 6 months of nevirapine-based generic highly active antiretroviral therapy in South India

Clin Infect Dis. 2007 Jan 15;44(2):295-300. doi: 10.1086/510491. Epub 2006 Dec 11.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / adverse effects*
  • Body Composition
  • Body Weight / drug effects*
  • CD4 Lymphocyte Count
  • Cohort Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • Humans
  • India / epidemiology
  • Lamivudine / adverse effects
  • Lamivudine / therapeutic use
  • Male
  • Nevirapine / adverse effects*
  • Nevirapine / therapeutic use*
  • Stavudine / adverse effects
  • Stavudine / therapeutic use
  • Zidovudine / adverse effects
  • Zidovudine / therapeutic use

Substances

  • Anti-HIV Agents
  • Lamivudine
  • Zidovudine
  • Nevirapine
  • Stavudine