LEVELS OF HIV RNA ARE QUANTITATIVELY RELATED TO PRIOR WEIGHT-LOSS IN HIV-ASSOCIATED WASTING

Thirty-three patients referred to a wasting clinic were evaluated to a ssess whether levels of HIV RNA were related to the magnitude of prior weight loss. Their median RNA level was 46,887 gene copies/ml (range, <200-510,070 gene copies/ml) at the time of referral. Patients had lo st 10.5 +/- 6.4 kg over 461 +/- 304 days. RNA levels were correlated w ith the absolute amount and percentage of weight lost as well as the d ifference in body mass index (BMI) at the prior maximal and minimal re corded weights (r = 0.7, 0.67, 0.69; p = .0001 for the comparisons). T he magnitude of these changes increased across strata of HIV RNA level s (p less than or equal to .004), previously defined as associated wit h increasing risk; for disease progression. The other parameter that c ould be associated with weight loss was the CD4 lymphocyte count (r = -0.43;p = .01). Low levels of testosterone and measures of body cell m ass, fat free mass, or fat mass within 6 weeks of the RNA level could not be related to weight loss. change in BMI, or RNA levels. Thirty-tw o of the patients had chronic, relentless weight loss; in 15 of these subjects, no apparent secondary opportunistic complications were assoc iated with weight loss or gastrointestinal symptoms to impair energy i ntake. Levels of HIV replication appear to be causally related to the magnitude of weight loss in some patients with wasting.