Weight Loss Remains an Important Predictor of Mortality

[Guest guest]

Weight Loss Remains an Important Predictor of Mortality

By Boyle, MD

Prior to the availability of highly active antiretroviral therapy (HAART), AIDS wasting led to significant morbidity and mortality among HIV-infected patients. Since HAART became available, many clinicians have seen a decline in the incidence and severity of wasting, but several studies have shown that wasting continues to be a problem, even in patients successfully treated with HAART.

In a study published in the Journal of Acquired Immune Deficiency Syndromes, investigators attempted to determine if HIV-related wasting is associated with decreased survival in patients receiving HAART and, if so, which measurement of wasting, including overall weight, fat-free mass, body cell mass, or fat mass, is most predictive of mortality.

The study enrolled 678 HIV-positive participants and weight, fat-free mass, body cell mass, and fat mass were measured at 6-month intervals. The investigators used proportional hazards models to estimate and compare the relative risks of death for each weight-related and adjust for potential confounders including HAART use, body mass index, and CD4+ T cell counts.

The investigators found that weight loss was the strongest independent predictor of mortality. In particular, weight loss of at least 10% from the patient's baseline or the previous visit was significantly associated with up to a 6-fold increase in mortality compared with maintenance or gaining of weight. In addition, even one episode of weight loss of at least 3% from baseline or at least 5% from the previous visit was also predictive of mortality.

The authors conclude, "despite the apparent benefits of HAART use on HIV-related survival, weight loss remains an independent predictor of mortality. In addition, fat-free mass or body cell mass estimated using bioelectrical impedance analysis does not add further prognostic value over weight loss."11/08/02Reference

A Tang and others. Weight Loss and Survival in HIV-Positive Patients in the Era of Highly Active Antiretroviral Therapy. Journal of Acquired Immune Deficiency Syndromes 2002; 31(2): 230-236.

Copyright 2002 by HIV and Hepatitis.com. All Rights Reserved.

Reproduction of articles for personal or educational use is encouraged and does not require permission from the publisher. Permission to re-print copyrighted articles is almost always granted, but does require written permission from the publisher (email webmaster@...)

Vergel

Program for Wellness Restoration, PoWeR

www.medibolics.com

www.facialwasting.org

Click to subscribe to lipodystrophy

"Nothing in the world can take the place of persistence. Talent will not; nothing is more common than unsuccessful people with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelics. Persistence and determination are omnipotent." Calvin Coolidge, 30th President of the US