Physical Effects of HIV-Associated Wasting Persist Long After Diagnosis

Researchers have found that HIV-related wasting affects men's physical strength and quality of life long after their wasting diagnosis, aidsmap reports. Their mental quality of life, however, was found to be higher than that of HIV-negative men.

The study compared 85 HIV-positive men who had survived at least two years after receiving a diagnosis of HIV-related wasting or otherwise showing severe weight loss with 249 HIV-positive men without such wasting and 338 HIV-negative men. All participants were enrolled in the long-term Multicenter AIDS Cohort Study, with the majority of study visits (80%) taking place after effective HIV therapy became available in 1996.

HIV-related wasting is defined as losing more than 10% of one's weight without meaning to do so, and either chronic diarrhea or more than one month of weakness and fever. The study defined severe weight loss as a body mass index (a measure of body fat) below 18.5kg/m2, long-term loss of 10% of one's weight or loss of 1%/kg of body weight each year during the follow-up period.

Men with HIV-related wasting compared with HIV-positive men without wasting were found to have:

  • lower grip strength and poorer physical quality of life (P ≤ .03)
  • lower median survival rate (9.1 years, compared to 11.6 years for HIV-positive men without wasting)
  • lower body weight four years after the wasting diagnosis (8-9 kg less than the HIV-positive comparison group)

They also suffered from twice as many potentially fatal health conditions on average compared with HIV-negative men without wasting. There was no significant difference in walking speed among the groups.

Investigators believe that the weight loss in those with HIV-related wasting "was associated largely with losses in lean mass [muscle], with subsequent regain largely representing fat mass. ... The persistent low body weight and mean gain of only 2kg over 4 years is of particular concern in regards to long-term consequences in our cohort."

An analysis of self-administered questionnaires regarding participants' mental quality of life, however, found that men with HIV-associated wasting had a better mental quality of life than HIV-negative men (P ≤ .05).