Document 1028
 DOCN  M94A1028
 TI    Risk factors for wasting in HIV 1 infected patients.
 DT    9412
 AU    Bentata M; Kerchouni R; N'Guyen G; Ferriere F; Uzzan B; Krivitzky A;
       Modigliani E; SIDA Unit, Hopital Avicenne, Bobigny, France.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):225 (abstract no. PB0912). Unique
       Identifier : AIDSLINE ICA10/94371547
 AB    OBJECTIVE: To estimate the influence of clinical, immunological and
       hormonal parameters and body composition compartments on weight loss in
       HIV 1 infected patients. METHODS: Unicentric prospective study of 70
       subjects (52 AIDS, 11 ARC, 7 asymptomatic patients--28 IVDU), during a
       mean follow-up of 16 months. Full clinical and laboratory examination
       included BMI, albumin, triglycerides, beta 2M, thyroid function tests
       (rT3, FT3, FT4, TSHus) and seric neopterin as a marker of immune
       activation. Fat and lean body mass (FW and LW) as well as basal
       metabolism (BM) were assessed by bioelectrical impedance and results
       expressed as FW/BMI, LW/BMI, BM/FW and BM/LW ratios. The weight loss was
       expressed in comparison with normal weight before illness (delta W/W).
       Statistical tests used mean +/- sem, Student's t test, one way ANOVA
       test and stepwise logistic regression. A p value < 0.05 was considered
       significant. RESULTS: The body weight loss was 8 +/- 1% (BMI = 21 +/-
       0.4 kg/m) despite a mean daily caloric intake of 2900 +/- 120 kcal.
       Independent factors in relation with delta W/W were CD4 cell count, beta
       2M, FW/BMI, LW/BMI and BM/FW. Significant clinical factors associated
       with weight loss were an AIDS defining event during the study (43.0%),
       encephalic opportunistic infections (28.6%), gastrointestinal symptoms
       (38.6%), but not the stage of the disease, the IV drug addiction or the
       socio-economic status. Twenty-seven patients lost more than 10% of body
       weight. In this group, rT3/FT3 and BM/LW, but not BM/FW, were
       significantly higher. Fifteen patients (21.4%) died with a delta W/W of
       21% and a BMI of 17 kg/m. MB/FW, MB/LW, neopterin and rT3/FT3 were
       significantly higher and FT3 lower. However, a significant positive
       correlation was found between FT3 and MB/LW, and between delta W/W and
       MB/LW or FT3. In 3 patients, the wasting syndrome was the only cause of
       death. CONCLUSION: Clinical risk factors and poor caloric intake are
       insufficient to explain the wasting syndrome. In patients with a weight
       loss > 10%, the loss of fat and lean body mass is associated with
       excessive basal metabolism, high neopterin, a marker of immune
       activation, and inappropriate thyroid status.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS  AIDS-Related
       Complex/COMPLICATIONS  Basal Metabolism  Body Composition
       Cachexia/*ETIOLOGY  Caloric Intake  Human  HIV Infections/*COMPLICATIONS
       Leukocyte Count  Prospective Studies  Risk Factors  Substance Abuse,
       Intravenous/COMPLICATIONS  Syndrome  Thyroid Hormones/BLOOD  T4
       Lymphocytes  Weight Loss  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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