Today's HIV Patients: Just as Heavy as the General Population

Study finds higher levels of obesity among infected individuals

SUNDAY, Aug. 7, 2005 (HealthDay News) -- 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 9 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."

More information

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
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