ART-related body composition changes in adult women in a semi-rural South African context

[摘要] ENGLISH ABSTRACT: The aim of this study was to investigate practical methods of monitoring AIDS relatedwasting and lipodystrophy in a resource-poor clinical setting with HIV infected women asthe population group of interest. Measurement of body composition changes usinganthropometry is both cost- and time-efficient. Various different skinfolds were taken andtwo different equations (the equations of Pollock et al. (1975) and Durnin and Womersley(1974) for calculating body fat were used to determine the most promising method ormethods of monitoring body composition changes in a clinical setting.Detailed anthropometric measurements were performed, as well as selected measurementsfor haematological parameters and quality of life (QoL) for a group of 8 participants onantiretroviral medication (ART group) and 6 participants who were not on treatment (TNgroup). New variables namely, intra-abdominal indicator (IAI) and a percent of ideal bodymass to percent of ideal arm circumference ratio (%IBW:%IAC) were investigated aspossible indicators of lipodystrophy. Although measurements were taken at various timepoints,three specific time-points were chosen for data-analysis for the ART group and twotime points for the TN group. These three time-points were, baseline (on the day ofrecruitment for TN participants and within one month before the initiation of treatment forART participants), short-term (2 to 12 weeks after treatment initiation or the baselinemeasurement or for the ART and the TN participants) and long-term (within one and a halfyear of treatment initiation for the ART group).ART and TN participants did not differ for many variables at baseline. The majordifferences between ART and TN were in measured and derived variables of the arm,especially percent of ideal arm circumference (%IAC) and upper arm fat area (UAFA),which were significantly lower in the ART group.CD4+ and QoL improved significantly for the ART participants from baseline to long-term.This was not associated with changes in muscle mass, but rather some fat mass variables.Participants on antiretroviral medication exhibited changes relating to abdominal obesity.It was concluded that antiretroviral therapy contributed greatly to the QoL of the participants and it probably aided in the recovery from wasting for at least one participantin this study. Measures of the arm can be used in a rural clinical setting to effectivelymonitor patients with regard to AIDS related wasting. The new variables IAI and%IBW:%IAC could be helpful in the monitoring of lipodystrophy and should beinvestigated in future research.

[发布机构] Stellenbosch University