This presentation focused on how the techniques needed to assess body composition in HIV patients have changed recently compared to the early period of the HIV epidemic. For example, early investigators faced with the problem of malnutrition, cachexia, weight loss and wasting in AIDS patients used techniques to assess reduction in skeletal muscle mass, total body protein and nitrogen. In contrast, use of HAART in recent time leads to alteration in body fat distribution. Therefore, to assess loss of subcutaneous fat and increased in visceral fat with HAART, newer techniques such as anthropometry (measuring body circumferences and skinfold thickness), dual energy X-ray absorptiometry (DEXA), computerized tomography (CT) and magnetic resonance imaging (MRI) are needed.

DEXA can be used to study changes in total body fat, fat in the extremities and truncal fat, but it fails to provide assessment of intra-abdominal or visceral fat for which CT or MRI are needed. Dr. Kotler's group uses a whole-body MRI technique in which they obtain images of 40 different anatomic regions. Measuring fat surface area at each slice and using the distance between the two consecutive slices, total body fat volume and mass can be calculated for various adipose tissue depots. Predictive values of various anthropometric techniques such as waist and hip circumferences, skinfolds for assessment of subcutaneous truncal or visceral fat in HIV-infected patients need to be studied.