Body weight changes with protease inhibitor treatment in undernourished HIV-infected patients

Effective reduction of HIV replication by protease inhibitor (PI) treatment was expected to reverse some of the weight loss associated with HIV infect ion. Body weight changes in undernourished HIV-infected patients starting P I treatment were compared to its virologic and immunologic effects. This wa s designed as a retrospective study using prospectively collected weight da ta; the setting was the HN outpatient department of a university hospital. Among 223 consecutive HIV-positive patients starting treatment with PI Febr uary 1996 to September 1997, 63 undernourished patients were evaluable. The main outcome measures were weight trend, calculated by Linear regression o f a patient's weight versus time, and its change from a 4-14-wk baseline pe riod to the first 14 wk, and 28 wk, after treatment. In our results, weight trend remained unchanged (baseline, + 0.4 +/- 4.0 kg/100 d; 14 wk, + 0.7 /- 4.1 kg/100 d, and 28 wk, + 1.0 +/- 3.4 kg/100 d, n.s.). Reduction of vir emia and increase in CD4 cell count were unrelated to weight trends. Treatm ent with PI did not result in an improved weight trend. Altered body compos ition with PI treatment, as observed in other studies, does not seem to res ult in body weight changes. Drug side effects may have counteracted any pos itive effects. The metabolic and nutritional impact of effective antiviral treatment merits further study. (C) Elsevier Science Inc. 1999.