Bioelectrical impedance analysis in HIV-infected patients treated with triple antiretroviral treatment

Background: Triple antiretroviral treatment including protease inhibitors ( PIs) delays the clinical progression of HIV infection and may thus reduce t he risk of malnutrition. However, fat redistribution (lipodystrophy) was re cognized recently as a metabolic side effect of PIs. Objective: The study aimed to assess the effect of triple antiretroviral tr eatment on body composition and on the prevalence of malnutrition. Design: Two cross-sectional studies, 1 in 1996 (t96; n = 247) and 1 in 1997 (t97: n = 266), were conducted in HIV-infected outpatients. Among patients who participated in both studies, 111 patients started a new antiretrovira l treatment including a PI between t96 and t97 and were studied longitudina lly. Total body water (TBW), intracellular water (ICW), extracellular water (ECW), and fat mass were estimated by monofrequency bioelectrical impedanc e analysis (BIA). Results: Prevalence of malnutrition was reduced by 30-50% from t96 tn t97 d epending On the definition used. In the longitudinal study, TBW and the rat io between ICW and ECW increased and fat mass decreased (P < 0.001). BIA in dicated a greater increase in ICW in 23 (21%) patients with clinically appa rent fat redistribution than in patients without this syndrome, but estimat es of fat mass changes were not significantly different. Conclusions: Triple antiretroviral treatment may protect HIV-infected patie nts against the development of malnutrition. Whole-body BIA data suggest an increase in appendicular body cell mass associated with improved antiretro viral treatment. However, the method is unreliable in detecting fat redistr ibution, and current prediction equations will need to be recalibrated for HIV-infected patients receiving highly active antiretroviral treatment.