AGE, GENDER, AND OTHER PREDICTORS OF THE WASTING SYNDROME AMONG HIV-1-INFECTED INJECTING DRUG-USERS

We conducted a study to identify predictors of the wasting syndrome am ong human immunodeficiency virus 1 (HIV-1)-seropositive injecting drug users. We enrolled 113 cases (defined as an unexplained loss of >10% baseline weight) and 226 controls (defined as <5% weight loss or any w eight gain) from a HIV-1 seropositive cohort of injecting drug users ( N = 630) into a nested case-control study. Crude predictors of wasting included: older age [odds ratio (OR) for a 1-year difference = 1.06], female gender (OR = 1.66), more years spent injecting drugs (OR for 1 -year difference = 1.05), presence of diarrhea (OR = 3.78), lower perc entage of CD4 T-lymphocytes (OR for 10-unit difference = 0.73), and hi gher log beta(2)-microglobulin concentration (OR for 1 log difference = 11.3). After adjusting for CD4 cell level, beta(2)-microglobulin con centration, diarrhea, gender, length and frequency of drug use, age, t he presence of thrush, and education, independent predictors of weight loss in HIV-seropositive injecting drug users were female gender (OR = 2.23) and increasing age (OR for 1-year difference = 1.06). Frequenc y and duration of drug use were not strongly associated with the odds of developing wasting syndrome in this HIV-1-seropositive cohort. Thes e data indicate that HIV wasting syndrome in injecting drug users is d istinct from complications of drug use.