Body composition of HIV-positive patients with pulmonary tuberculosis: a cross-sectional study in Mwanza, Tanzania

TY - JOUR

T1 - Body composition of HIV-positive patients with pulmonary tuberculosis

T2 - a cross-sectional study in Mwanza, Tanzania

AU - Range, N.S

AU - Malenganisho, W.

AU - Temu, M.M.

AU - Changalucha, J.

AU - Magnussen, Pascal

AU - Krarup, Henrik Bygum

AU - Andersen, A.B.

AU - Friis, Henrik

PY - 2010/1

Y1 - 2010/1

N2 - To estimate the weight deficit and body composition of cases of pulmonary TB (PTB), and assess the roles of HIV and the acute-phase response, a cross-sectional study was carried out in Tanzania. Weight, body mass index (BMI), arm muscle area (AMA), arm fat area (AFA) and the serum concentration of the acute-phase protein a1-antichymotrypsin (serum ACT) were evaluated for each of 532 cases of PTB and 150 'non-TB' controls. On average, the female cases of PTB not only weighed 7.8 kg less but also had BMI that were 3.1-kg/m2 lower, AMA that were 14.8-cm2 lower, and AFA that were 7.6-cm2 lower than those seen in the female subjects without TB. Similarly, on average, the male cases of PTB weighed 7.1 kg less and had BMI that were 2.5-kg/m2 lower, AMA that were 18.8-cm2 lower and AFA that were 1.6-cm2 lower than those seen in the male subjects without TB. Although HIV infection was associated with a 1.7-kg lower weight and a 0.6-kg/m2 lower BMI (with deficits in both AMA and AFA) among males, it was not associated with any such deficits among the female subjects. Elevated serum ACT was found to be a negative predictor of BMI, AMA and AFA, partially explaining the effects of the PTB but not those of the HIV. There is need for a better understanding of the determinants and effects of loss of fat and lean body mass in HIV-positive tuberculosis.

AB - To estimate the weight deficit and body composition of cases of pulmonary TB (PTB), and assess the roles of HIV and the acute-phase response, a cross-sectional study was carried out in Tanzania. Weight, body mass index (BMI), arm muscle area (AMA), arm fat area (AFA) and the serum concentration of the acute-phase protein a1-antichymotrypsin (serum ACT) were evaluated for each of 532 cases of PTB and 150 'non-TB' controls. On average, the female cases of PTB not only weighed 7.8 kg less but also had BMI that were 3.1-kg/m2 lower, AMA that were 14.8-cm2 lower, and AFA that were 7.6-cm2 lower than those seen in the female subjects without TB. Similarly, on average, the male cases of PTB weighed 7.1 kg less and had BMI that were 2.5-kg/m2 lower, AMA that were 18.8-cm2 lower and AFA that were 1.6-cm2 lower than those seen in the male subjects without TB. Although HIV infection was associated with a 1.7-kg lower weight and a 0.6-kg/m2 lower BMI (with deficits in both AMA and AFA) among males, it was not associated with any such deficits among the female subjects. Elevated serum ACT was found to be a negative predictor of BMI, AMA and AFA, partially explaining the effects of the PTB but not those of the HIV. There is need for a better understanding of the determinants and effects of loss of fat and lean body mass in HIV-positive tuberculosis.

U2 - 10.1179/136485910x12607012373830

DO - 10.1179/136485910x12607012373830

M3 - Journal article

SN - 2047-7724

VL - 104

SP - 81

EP - 90

JO - Pathogens and Global Health

JF - Pathogens and Global Health

IS - 1

ER -