Body
shape changes are among the most disturbing side effects associated with HIV and
its treatment, and lead many women
to delay or interrupt therapy.
A
study reported in the March 1, 2008 Journal of Acquired Immune Deficiency Syndromes
shed further light on the relationship between indicators of central adiposity
(abdominal fat accumulation) such as waist-to-hip ratio (WHR) and waist circumference
and HIV infection, antiretroviral
therapy, or both.
Jessica Justman and colleagues measured waist and
hip circumference and body mass index (BMI) among 942 HIV positive and 266 HIV
negative participants in the Women's Interagency HIV Study semiannually from 1999
through 2004. Nearly two-third (62%) were African American and 25% were Hispanic,
with an average age of 41 years.
BMI
is a measure of weight relative to height. BMI above 25 is considered overweight
and above 30 is considered obese. A higher WHR (i.e., over 0.80), indicated by
an "apple" body shape, is considered a greater risk factor for heart
disease compared with a lower WHR, or a "pear" shape, among women of
similar weight.
Results
•
The average
BMI at study entry was 28 for HIV positive women and 29.5 for HIV negative women.
•
The average
WHR at study entry was 0.90 for HIV positive women and 0.88 for HIV negative women.
•
WHR was significantly
larger, whereas BMI and waist and hip circumference were significantly smaller,
among HIV positive compared with HIV negative women at almost all 11 follow-up
visits.
•
Among HIV negative
women, mean waist and hip circumference and BMI increased over the 5-year study
period:
•
Waist: +4.1
cm or 4.4%; •
Hip: +3.76
cm or 3.5%; •
BMI: +2.43
kg/m2 or 8.2%; •
WHR remained
stable.
•
Among the HIV
positive women, waist and hip circumference, BMI, and WHR did not change significantly.
•
Independent
predictors of lower BMI among HIV positive women included:
•
White race; •
Hepatitis C
virus (HCV) coinfection; •
Current tobacco
smoking; •
Higher HIV
viral load; •
Lower CD4 cell
count.
•
Independent
predictors of larger WHR among HIV positive women included:
•
Older age; •
White and other
non-African American race; •
Higher CD4
cell count; •
Protease inhibitor
use.
"HIV-infected
women had higher WHRs compared with HIV-uninfected women, despite lower BMIs and
waist and hip measurements," the investigators concluded.
"BMI
and waist and hip circumference increased over 5 years among the HIV-uninfected
women but remained stable in the HIV-infected women," they added. "Among
HIV-infected women, PI use was associated with a larger WHR, although HAART use
itself was not appreciably associated with BMI or WHR."
5/16/08
Reference JE
Justman, DR Hoover, Q Shi, and others. Longitudinal Anthropometric Patterns Among
HIV-Infected and HIV-Uninfected Women. Journal of Acquired Immune Deficiency
Syndromes 47(3): 312-319. March 1, 2008.
A
study reported in the March 1, 2008 Journal of Acquired Immune Deficiency Syndromes
shed further light on the relationship between indicators of central adiposity
(abdominal fat accumulation) such as waist-to-hip ratio (WHR) and waist circumference
and HIV infection, 
BMI
is a measure of weight relative to height. BMI above 25 is considered overweight
and above 30 is considered obese. A higher WHR (i.e., over 0.80), indicated by
an "apple" body shape, is considered a greater risk factor for heart
disease compared with a lower WHR, or a "pear" shape, among women of
similar weight.
