Ah. Shevitz et al., Elevated resting energy expenditure among HIV-seropositive persons receiving highly active antiretroviral therapy, AIDS, 13(11), 1999, pp. 1351-1357
Objectives: To ascertain the relationships between resting energy expenditu
re (REE), HIV RNA in plasma, and highly active antiretroviral therapy (HAAR
T).
Design: Cross-sectional analysis using data of a large cohort study of nutr
ition in relation to HIV disease.
Methods: HIV RNA in plasma, REE, fat-free mass (FFM), and medication regime
ns were assessed at 530 visits among 372 participants in a cohort study of
HIV-seropositive men and women.
Results: HIV RNA in plasma was directly correlated with REE. After adjustme
nt for FFM, age, CD4 cell count and HAART use, there was an increase in REE
of 90 kJ/day per log(10) copies/ml increase in HIV RNA [95% confidence int
erval (CI) 16-164; P = 0.02). HAART use had an independent effect on REE. I
n patients reporting HAART use, adjusted REE was 339 kJ/day higher than in
those not reporting HAART use (95% CI 177-501; P = 0.0001).
Conclusions: Viral load and HAART appear to exert independent effects on RE
E. Although HAART may decrease metabolic rate by lowering viral burden, it
appears to increase metabolic demands through some mechanism(s) independent
of its effect on viral burden. This may result in elevated REE despite con
trol of viral replication. (C) 1999 Lippincott Williams & Wilkins.