BODY-MASS INDEX COURSE IN ASYMPTOMATIC HIV-INFECTED HOMOSEXUAL MEN AND THE PREDICTIVE VALUE OF A DECREASE OF BODY-MASS INDEX FOR PROGRESSION TO AIDS

Weight loss is a common characteristic of advanced stages of HIV infec tion. Weight changes during the asymptomatic stage of HIV infection ha ve not been well documented and the possible predictive value of early weight loss for progression to AIDS is unknown. In 122 HIV seroconver ters, the natural course of body mass index (BMI) following seroconver sion was studied. No BMI decline was seen immediately following seroco nversion. In the 56 AIDS cases, however, a steep BMI decline of 1.14 k g/m(2) occurred 6 months before AIDS. This BMI decline was more pronou nced in those with low CD4(+) T cell counts (<100 x 10(6)/L) at the ti me of AIDS diagnosis (1.8 kg/m(2)). The relative hazard for progressio n to AIDS BE a BMI decline of 1.14 kg/m(2) per 6 months was 3.1, which remained similar after adjustment for CD4 count and p24 antigenemia. We conclude that the course of BMI in HIV-1 infection is biphasic: a r elatively stable period is followed by a rapid decline in the 6 months preceding onset of AIDS. Furthermore, we found that this steep BMI de cline was associated with faster progression to AIDS.