Drug Use and Other Risk Factors Related to Lower Body Mass Index Among HIV-Infected Individuals

Noting that malnutrition is associated with morbidity and mortality in HIV-infected persons, the authors wrote that little research has sought to identify the roles that clinical, illicit drug use and socioeconomic characteristics play in these patients’ nutritional status.

The researchers conducted a cross-sectional analysis that included 562 HIV-positive individuals enrolled in the Nutrition for Healthy Living study conducted in Boston and Providence, R.I. Using linear regression, they examined the relationship between body mass index (BMI) and certain covariates (type of drug use, demographic, and clinical characteristics).

Drug users overall had a lower BMI than did non-users. After adjusting for other covariates (p=0.02) the BMI of cocaine users was 1.4 kg/m2 less than that of participants who did not use any drugs. The BMI of participants who were older than 55 was 2.0 kg/m2 less than that of patients under age 35, and BMI increased by 0.3kg/m2 with each 100 cells/mm3 increase in CD4 count. In the final model, the following were found not to be associated with BMI: highly active antiretroviral therapy use, adherence to HAART, energy intake, AIDS status, hepatitis B and C co-infections, cigarette smoking and depression.

"In conclusion, BMI was lower in drug users than in non-drug users, and was lowest in cocaine users," the authors wrote. "BMI was also directly associated with CD4 count and inversely related to age more than 55 years old. HIV-infected cocaine users may be at higher risk of developing malnutrition, suggesting the need for anticipatory nutritional support."

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