Virologic, immunologic, and immune activation markers as predictors of HIV-associated weight loss prior to AIDS. Multicenter AIDS Cohort Study.

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Virologic, immunologic, and immune activation markers as predictors of HIV-associated weight loss prior to AIDS. Multicenter AIDS Cohort Study.

J Acquir Immune Defic Syndr. 1999 Dec 1;22(4):386-94. Unique Identifier : AIDSLINE MED/20097667
Lyles RH; Tang AM; Smit E; Mellors JW; Margolick JB; Visscher BR; Phair JP; Graham NM; Emory University, Atlanta, Georgia, USA.

Abstract: OBJECTIVES: To study weight patterns among HIV-positive men and associations of baseline HIV RNA, CD4+ lymphocyte count, and serum levels of neopterin and beta2-microglobulin with subsequent weight loss prior to AIDS. METHODS: A cohort of 1558 homosexual men from the Multicenter AIDS Cohort Study comprised the main study population. Marker values obtained using samples from a baseline visit in 1984 to 1985 were associated with weight patterns and risk of weight loss events over 10 years of follow-up. To investigate the impact of protease inhibitor (PI) therapy on weight patterns, a separate analysis was conducted for men who initiated such therapy in 1995 to 1996. RESULTS: In general, HIV-positive men demonstrated a striking tendency toward weight loss, with a rate of decline that increased over time. Distinct variations in this pattern were observed according to baseline HIV RNA levels. Each marker considered was independently predictive of weight loss events. Following use of PIs, 68 men showed a tendency toward increased weight, compared with men who did not use PIs. CONCLUSIONS: Although baseline virologic, immunologic, and immune activation markers all predicted weight loss events in AIDS-free HIV-positive men, HIV RNA displayed the best discrimination. Shifts in weight patterns observed in this cohort after PI therapy call for further attention to nutritional and body changes as the duration of therapy increases.

Keywords: CLINICAL TRIAL JOURNAL ARTICLE MULTICENTER STUDY beta 2-Microglobulin/BLOOD Adult Body Weight Cohort Studies CD4 Lymphocyte Count Human HIV/*PHYSIOLOGY HIV Infections/*DRUG THERAPY/IMMUNOLOGY/*PHYSIOPATHOLOGY/VIROLOGY HIV Protease Inhibitors/*THERAPEUTIC USE HIV Wasting Syndrome/*ETIOLOGY Male Neopterin/BLOOD Predictive Value of Tests RNA, Viral/*BLOOD Support, U.S. Gov't, P.H.S. Weight Gain *Weight Loss

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A0040853

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