Endocrine Abstracts

Background: We compared body composition parameters in older HIV-positive individuals on stable antiretroviral therapy to age-matched HIV-seronegative individuals to assess whether differences in body composition parameters persist in the era of potent antiretroviral therapy.

Methods: Inclusion criteria to the ageing HIV cohort required subjects to be >40 years old and be on stable antiretroviral therapy for >6 months. Only subjects with undetectable plasma HIV RNA (<50 copies/ml) were included to eliminate the effects of uncontrolled HIV disease. Weight and height were measured in triplicate and averaged. Body composition (total fat, trunk fat, peripheral fat, lean tissue, and bone mineral content) was measured by dual-energy X-ray absorptiometry (DXA) using Lunar Prodigy scanner (GE Medical Systems, Inc., Milwaukee, WI, USA). Statistical analyses utilised were Wilcoxon’s rank-sum test, χ² test, and multivariate linear regression.

Results: Body composition parameters from 133 HIV-positive individuals were compared to 74 HIV-seronegative controls. HIV-positive individuals were younger than HIV-seronegatives (medians: 51 years vs 54 years, P=0.04), and comprised of more males (88% vs 80%, P<0.001). Among HIV-positive individuals, the median CD4 count was 510 cells/μl. HIV-positive individuals had similar BMI (25.9 kg/m² vs 26.8 kg/m², P=0.25), but lower total fat (medians: 20.168 g vs 24.817 g, P=0.005) which was accounted for by differences in peripheral fat (6.811 g vs 9.634 g, P<0.001) with similar truncal fat levels. In a multivariate linear regression model, HIV status was a significant risk factor for lower peripheral fat content, adjusting for age, gender, ethnicity (Caucasian or non-Caucasian), BMI and past use of zidovudine or stavudine (β=−0.08, P=0.02).

Conclusion: Infection with HIV is still characterized by differences in body composition despite use of potent antiretroviral therapy. Specifically, HIV is associated with lower peripheral fat content independent of past use of antiretroviral therapy known to cause peripheral fat loss.

Disclosure: This work was supported by NIH grants R01HL095135 (C Shikuma) and U54RR026136 (J Hedges).