WEIGHT-LOSS AS A PREDICTOR OF SURVIVAL AND DISEASE PROGRESSION IN HIV-INFECTION

Severe weight loss in HIV is associated with decreased length of survi val. It is unclear whether mild weight loss is associated with an incr eased risk of death or opportunistic complications of HIV. Participant s in four interventional studies (n = 2382) conducted by a community-b ased clinical trials network were evaluated for percentage change in w eight during their first 4 months in the study. Proportional hazards m odels were performed for the occurrence of opportunistic complications and death subsequent to the if-month visit. The relative risk of deat h and opportunistic complications for those with 5% to 10% weight loss over 4 months was 2.22 (p <.001) and 1.89 (p <.001), respectively, an d 1.26 (p <.01) and 1.19 (p <.01) among those who lost 0% to 5% of the ir body weight, respectively, when compared with those with no weight loss. Among those who lost 5% to 10% of their body weight, the relativ e risk of individual opportunistic complications increased significant ly, including Pneumocystis carinii pneumonia (PCP) (1.61; p <.01), cyt omegalovirus (CMV) (2.33; p < .001), and Mycobacterium avium complex ( MAC) (1.81; p <.01). As little as 5%t weight loss over a 4-month perio d is associated with increased risk of death and opportunistic complic ations in HIV. A weight loss of 5% to 10% is also associated with an i ncreased risk of individual opportunistic complications.