Body composition and quality of life changes in HIV infection

As the efficacy of clinical management of HIV infection continues to improve, there is a growing need for outcomes research to focus on finding ways to improve physical well-being and quality of life. Weight loss and body cell mass (BCM) depletion are two clinical issues that have received ongoing attention from researchers, given that both are potent predictors of morbidity in HIV-infected individuals. In this series of studies, three primary issues were addressed. First, the relationship between pharmacological (oxandrolone) and nutritional therapies and changes in BCM and body weight was examined over a 4-mo descriptive clinical trial. Second, the impact of these changes was considered in terms of quality of life change. Third, these analyses provided an opportunity to compare single-frequency bioelectrical impedance with multi-frequency bioelectrical impedance methods for measuring BCM change. There were a number of compelling findings in this research. First, HIV-infected individuals receiving oxandrolone and nutritional intervention were observed to gain both body weight and BCM. Significant relationships were observed between weight gain and improved quality of life, physical well-being, and appetite. In addition to these results, the use of bioimpedance spectroscopy (BIS) was demonstrated to have several advantages over the more commonly used single-frequency bioelectrical impedance method for measuring BCM in the field, including the ability to provide valid measures of BCM in HIV infection. Based on these findings, it appears that early identification by a valid field method, BIS, and a multi-faceted therapeutic approach may be most effective in the treatment of weight loss and BCM depletion in HIV-infected individuals