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The weight loss and
wasting syndrome long associated with AIDS has now been replaced - for some
HIV-positive people who have not progressed to AIDS - by obesity, according
to a new study being presented today at an infectious-disease meeting in San
Diego. Doctors
report there is a growing need for
HIV patients to be screened for obesity,
which raises the risk of diabetes, high blood pressure and cholesterol. "We
used to worry that they would lose weight and become wasted," said Dr. Nancy
Crum-Cianflone of San Diego's TriService AIDS Clinical Consortium. "Maybe we
should redirect our concerns to making sure they are maintaining a healthy,
normal weight."
At the height of the
US AIDS epidemic, many patients experienced wasting syndrome, the
uncontrollable loss of greater than 10 percent of body weight, along with
symptoms like diarrhea and fever. Medical advances have resulted in more HIV
patients living longer than their counterparts two decades ago, causing them
to be prone to the same habits as uninfected Americans - poor eating choices
and lack of exercise.
After observing that
her patients were steadily getting fat, Crum-Cianflone decided to study how
prevalent obesity was in the HIV population. She and her colleagues analyzed
the medical records of 663 HIV patients at Navy hospitals in San Diego and
Bethesda, Md. The researchers looked at medical records, duration of HIV
infection, and whether patients had a history of diabetes or high blood
pressure.
Sixty-three percent of
the patients were overweight or obese, while just 3 percent were
underweight, and none were considered to be "wasted." Among those with fully
developed AIDS, around 30 percent were overweight or obese, the researchers
found.
The numbers are
especially striking considering that most of the study participants were in
the military and tended to be in better shape. Previous research has
suggested that around 40 percent of HIV patients are overweight.
The study did not show
a link between excess weight and AIDS drugs. Patients who gained weight
tended to put on an average of 13 pounds over a decade. Those who become
infected younger, were infected for a longer time, or had high blood
pressure were more likely to get fat.
The rise in obesity
among HIV patients appears to mirror the US population in general. "These
folks are in more ways than not becoming like everyone else," said Dr.
Michael Saag, Director of the AIDS Center at the University of
Alabama-Birmingham, who was not connected with the study. "If they're
overeating, they're going to get fat."
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