Dietary intake and body composition in HIV-positive and -negative South African women

Objective The present paper examines dietary intake and body composition in antiretroviral (ARV)-naïve HIV-positive compared with HIV-negative South African women, as well as the impact of disease severity on these variables. Design Baseline data from a longitudinal study assessing bone health in HIV-negative and HIV-positive premenopausal South African women over 18 years of age were used. Anthropometry and body composition, measured by dual energy X-ray absorptiometry, were analysed together with dietary intake data assessed using an interviewer-based quantitative FFQ. Setting Soweto, Johannesburg, South Africa. Subjects Black, urban South African women were divided into three groups: (i) HIV-negative (HIV^-; n 98); (ii) HIV-positive with preserved CD4 counts (HIV⁺ non-ARV; n 74); and (iii) HIV-positive with low CD4 counts and due to start ARV treatment (HIV⁺ pre-ARV; n 75). Results The prevalence of overweight and obesity was high in this population (59 %). The HIV⁺ pre-ARV group was lighter and had a lower BMI than the other two groups (all P < 0·001). HIV⁺ pre-ARV women also had lower fat and lean masses and percentage body fat than their HIV^- and HIV⁺ non-ARV counterparts. After adjustment, there were no differences in macronutrient intakes across study groups; however, fat and sugar intakes were high and consumption of predominantly refined food items was common overall. Conclusion HIV-associated immunosuppression may be a key determinant of body composition in HIV-positive women. However, in populations with high obesity prevalence, these differences become evident only at advanced stages of infection.