Serial assessment of the nutritional status of patients infected with human inmunodeficiency virus. Role of the tumoral necrosis factor/receptor system

In order to analyze the nutritional status of HIV infected patients and the involvement of the tumour necrosis factor-alpha (TNF-alpha) and its solubl e receptors (sTNFRI and sTNFRII) in such an status, forty HIV infected pati ents, with no associated systemic opportunist infections, were prospectivel y followed for eight months. From each patient the following were obtained: clinical history, dietetic survey, anthropometric measurements, CD4+ T lym phocyte/mm(3) count, HIV load, and serum concentrations of TNF and sTNFRI a nd sTNFRII. Patients showed a nutritional disorder which involved mainly th e fat compartment (mean tricipital skin fold 9.8 +/- 4.2 mm, that is, 65.7 +/- 27.4% of the ideal fold), associated with a hypocaloric intake (mean da ily intake 1,659.5 +/- 543.0 kcal), with normal proportions of the differen t organic principles. Serum concentrations of TNF (87.9 +/- 79.2 vs 8.7 +/- 6.1 pg/ml, p = 0,048) and its receptors, sTNFRI (6.1 +/- 2.6 vs 1.0 +/- 0. 8 pg/ml, p < 0.001) and sTNFRII (41.9 +/- 18.6 us 6.3 +/- 3.6 pg/ml, p < 0. 001) were significantly higher than those detected in a sample of ten healt hy controls. No correlation was found? between nutritional alterations and concentrations ob: TNF or its receptors, viral load, and counts of CD4+ T l ymphocytes/mm(3). Seventeen patients completed the follow-up period. During this period, no significant modifications in the analyzed parameters were observed: tricipital skin fold, arm circumference, serum concentrations of albumin or transferrin, concentrations of tumoral necrosis factor or its re ceptor and caloric intake. The conclusion is that, despite the detected nut ritional alterations in the nutritional status and those in the TNF/recepto r system, our data no support and interrelationship between them.