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Today's HIV Patients: Just As
Heavy As
The General Population
As they become healthier
and live longer lives, people infected with HIV are now facing
an unexpected new threat: obesity.
University of Pennsylvania researchers report that 45 percent
of HIV-positive people studied were overweight or obese. That's
not especially high: it's about the same as the general population.
But the number is striking considering that just a decade ago,
many HIV patients went on to develop AIDS and wasted away as
they headed toward death.
A generation of drugs introduced in the mid-1990s has extended
the life spans of people with HIV, the virus that causes AIDS,
and allowed them to live fairly normal lives.
Study co-author Dr. Valerianna Amorosa and her colleagues noticed
in recent years that infected individuals had started to pack
on the pounds.
"It looked like they were getting obese just like anyone else," said
Amorosa, clinical assistant professor of infectious diseases
at the University of Pennsylvania.
Amorosa and her colleagues launched an obesity study, examining
the medical records of 1,669 HIV-positive patients who had visited
several local Philadelphia hospitals since 1999. Nearly 80 percent
were men, and 60 percent were black.
While Latinos were underrepresented, the sample was pretty much
an accurate snapshot of the HIV-infected population in Philadelphia,
Amorosa said.
The findings appear in the Aug. 15 issue of the Journal
of Acquired Immune Deficiency Syndromes .
According to the report, 31 percent of the patients were defined
as being overweight because they had body mass indexes -- a ratio
of height to weight -- between 25 and 30. Those with body mass
indexes higher than 30 -- making them obese -- made up 14 percent
of the patients.
A 5-foot, 4-inch person would need to weigh 175 pounds or more
to be obese; the scales would have to top 221 pounds for a 6-foot
tall person.
"Now, people are resuming more normal lives, but they're not
resuming more fit lives," said Dr. Michael Horberg, director
of HIV/AIDS policy at the Kaiser Permanente Health Plan, in Santa
Clara, Calif.
Only 9e percent of the people in the study were found to be
suffering from "wasting," a once-common condition in AIDS patients
in which they became thinner as their illness progressed.
Although their overweight rates were about the same, women were
more likely to be obese than men. Confirming common assumptions
about tobacco use, smokers were less likely to be fat, the researchers
found.
Amorosa acknowledged that study participants might be much happier
to be obese, especially if they worry about becoming sick and
like the idea of a buffer of excess weight. "Clearly, that's
the case for some patients: they're not unhappy to be obese."
Still, she said, obesity isn't healthy. Whether they're infected
with HIV or not, overweight people tend to suffer from a variety
of health conditions, from diabetes and heart disease to arthritis
and sleep apnea.
The study didn't examine whether AIDS drugs could be inadvertently
contributing to weight gain; the medications have already been
linked to higher cholesterol levels.
Gay men, who tend to smoke and drink more than the rest of the
population, may be at special risk of developing health problems
because of obesity, said Kaiser Permanente's Horberg. "Weight
control," he said, "is essential."
Learn more about HIV prevention and treatment from the National
Institute of Allergy & Infectious Diseases .
SOURCES: Valerianna Amorosa, M.D., clinical assistant professor,
infectious diseases, University of Pennsylvania, and chief, infectious
diseases, Philadelphia VA Hospital; Michael Horberg, M.D., director,
HIV/AIDS policy, quality improvement, and research, Kaiser Permanente,
Santa Clara, Calif.; Aug. 15, 2005, Journal of Acquired Immune
Deficiency Syndromes
Reference
Source 62
August
7,
2005
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