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IDSA: Obesity May Affect CD4 Cell Counts in HIV Patients

CD4 count increases found to be significantly less in obese patients than in normal-weight patients

MONDAY, Nov. 2 (HealthDay News) -- In HIV-positive patients, obesity may have a negative impact on CD4 cell counts, according to research presented at the annual meeting of the Infectious Diseases Society of America, held from Oct. 29 to Nov. 1 in Philadelphia.

Nancy F. Crum-Cianflone, M.D., of the Infectious Disease Clinical Research Program in Bethesda, Md., and colleagues studied 1,119 HIV seroconverters who were documented in a 1986 to 2008 prospective Natural History Study, 441 (39 percent) of whom were overweight and 96 (9 percent) of whom were obese at the time of diagnosis.

The researchers found that mean CD4 cell counts at diagnosis were 526, 551, 542, and 499 for underweight, normal, overweight, and obese patients, respectively. Results were similar during the pre-highly active antiretroviral treatment (HAART) and HAART eras. In contrast to the pre-HAART era, however, they found that obesity in the HAART era was associated with less beneficial changes in post-diagnosis mean CD4 cell counts compared to normal weight and overweight. Obese patients had significantly smaller increases in CD4 cell count than normal-weight patients.

"Although higher body mass index was associated with less reduction in CD4 counts over time in the pre-HAART era, excessive weight was not similarly associated with benefit in the HAART era," the authors conclude. "Being either underweight or obese in the HAART era was associated with smaller CD4 count rises. These data suggest that lower CD4 counts may be another adverse consequence of obesity."

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