TY - JOUR
T1 - HIV-related wasting in HIV-infected drug users in the era of highly active antiretroviral therapy
AU - Campa, Adrians
AU - Yang, Zhifang
AU - Lai, Shenghan
AU - Xue, Lihua
AU - Phillips, J. Craig
AU - Sales, Sabrina
AU - Page, J. Bryan
AU - Baum, Marianna K.
PY - 2005/10/15
Y1 - 2005/10/15
N2 - Background. A decrease in the rate of human immunodeficiency virus (HIV) infection-related wasting has been reported in the era of highly active antiretroviral therapy (HAART). We investigated this concern in a hard-to-reach population of HIV-infected drug users in Miami, Florida. Methods. After informed consent was obtained, 119 HIV-infected drug users were administered questionnaires involving demographic, medical history, and food-security information. Blood samples were drawn for immunological and viral studies. HIV-related wasting over a period of ≥6 months was denned as a body mass index of <18.5 kg/m2, unintentional weight loss of ≥10% over 6 months, or a weight of <90% of the ideal body weight. Results. The prevalence of HIV-related wasting was 17.6%. A significantly higher proportion of those who experienced wasting (81%) reported that there were periods during the previous month when they went for ≥1 day without eating (i.e., food insecurity), compared with those who did not experience wasting (57%). Although a greater percentage of patients who experienced wasting were receiving HAART, their HIV RNA levels were more than twice as high (mean ± standard deviation [SD], 166,689 ± 238,002 copies/mL; median log HIV RNA level ± SD, 10.2 ± 2.7 log10 copies/mL) as those for the group that did not experience wasting (mean ± SD, 72,156 ± 149,080; median log HIV RNA level ± SD, 9.2 ± 2.3 log10 copies/mL). Participants who experienced wasting were more likely to be heavy alcohol drinkers and users of cocaine. In multivariate analysis that included age, sex, food security, alcohol use, cocaine use, viral load, and receipt of antiretroviral therapy, the only significant predictors of wasting were ≥1 day without eating during the previous month (odds ratio [OR], 1.96; 95% confidence interval [CI], 1.18-3.26; P = .01) and viral load (OR, 1.64; 95% CI, 1.00-2.69; P = .05). Conclusions. HIV-related wasting continues to be common among HIV-infected drug users, even among HAART recipients. Food insecurity and viral load were the only independent predictors of wasting. The social and economic conditions affecting the lifestyle of HIV-infected drug users constitute a challenge for prevention and treatment of wasting.
AB - Background. A decrease in the rate of human immunodeficiency virus (HIV) infection-related wasting has been reported in the era of highly active antiretroviral therapy (HAART). We investigated this concern in a hard-to-reach population of HIV-infected drug users in Miami, Florida. Methods. After informed consent was obtained, 119 HIV-infected drug users were administered questionnaires involving demographic, medical history, and food-security information. Blood samples were drawn for immunological and viral studies. HIV-related wasting over a period of ≥6 months was denned as a body mass index of <18.5 kg/m2, unintentional weight loss of ≥10% over 6 months, or a weight of <90% of the ideal body weight. Results. The prevalence of HIV-related wasting was 17.6%. A significantly higher proportion of those who experienced wasting (81%) reported that there were periods during the previous month when they went for ≥1 day without eating (i.e., food insecurity), compared with those who did not experience wasting (57%). Although a greater percentage of patients who experienced wasting were receiving HAART, their HIV RNA levels were more than twice as high (mean ± standard deviation [SD], 166,689 ± 238,002 copies/mL; median log HIV RNA level ± SD, 10.2 ± 2.7 log10 copies/mL) as those for the group that did not experience wasting (mean ± SD, 72,156 ± 149,080; median log HIV RNA level ± SD, 9.2 ± 2.3 log10 copies/mL). Participants who experienced wasting were more likely to be heavy alcohol drinkers and users of cocaine. In multivariate analysis that included age, sex, food security, alcohol use, cocaine use, viral load, and receipt of antiretroviral therapy, the only significant predictors of wasting were ≥1 day without eating during the previous month (odds ratio [OR], 1.96; 95% confidence interval [CI], 1.18-3.26; P = .01) and viral load (OR, 1.64; 95% CI, 1.00-2.69; P = .05). Conclusions. HIV-related wasting continues to be common among HIV-infected drug users, even among HAART recipients. Food insecurity and viral load were the only independent predictors of wasting. The social and economic conditions affecting the lifestyle of HIV-infected drug users constitute a challenge for prevention and treatment of wasting.
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U2 - 10.1086/444499
DO - 10.1086/444499
M3 - Article
C2 - 16163638
AN - SCOPUS:26444594914
SN - 1058-4838
VL - 41
SP - 1179
EP - 1185
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 8
ER -