AIDSWEEKLY Plus, Monday, 17 March 1997
Daniel J. DeNoon, Senior Editor
Increases in resting energy expenditure (REE) in people with HIV infection appear to be related to viral load.
The determinants of high REE variability in the context of HIV disease have been a mystery since the first reports of the phenomenon.
Now that viral load has been linked definitively to HIV disease progression, K. Mulligan and colleagues of the University of California, San Francisco, measured viral load and REE in 36 clinically stable men with HIV infection.
They reported their findings at the Fourth Conference on Retroviruses and Opportunistic Infections, held January 22-26 in Washington, D.C.
"Our results suggest that either REE increases as part of the host response to increases in HIV or that the increase in REE reflects the exaggerated host immune responses seen in HIV(+) individuals," they wrote in their presentation abstract.
Mulligan et al. measured REE by indirect calorimetry and dual-energy X-ray absorptiometry evaluation of lean body mass (LBM). Study participants were 29 to 52 years old. Their baseline body mass indices ranged from 18.1 to 31.3 kg/m(2). Their REE ranged from 88 percent to 136 percent of the predicted mean (112 +/- 2 percent) and their plasma viral loads ranged from 0.5 to 472x10(3) HIV RNA copies/mL.
"We noted a significant positive correlation between HIV RNA levels and REE, adjusted for LBM (r=0.404, P=0.011)," Mulligan et al. reported.
Noting that vaccination is known to cause a transient increase in HIV viral load, the researchers measured REE in five HIV positive and four HIV negative men before and after influenza vaccination.
REE in the HIV negative men remained unchanged, while the men with HIV infection had a mean REE increase of 5.5 percent (1.94 +/- 0.41 kcal/kg LBM/day; P=0.006).
"Whether sustained reduction of HIV RNA levels with potent antiretroviral therapies will decrease REE and blunt the response to immune activation remains to be determined," Mulligan et al. wrote.
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