Why Might Weight Gain Increase With Art
Prior to the widespread release of ART in high-income countries in 1996, some people with HIV experienced inadvertent weight loss that in some cases could become severe. This was commonly called the wasting syndrome. When analyses were done, researchers found that affected people tended to lose muscle mass.
The causes of weight loss in untreated HIV infection are complex and may be related to intestinal inflammation and injury from infections, altered metabolism, decreased levels of hormones such as testosterone, and loss of appetite.
Once ART became available in 1996, researchers reported increased weight in patients, particularly those who had been suffering from the wasting syndrome, though this increased weight was mostly due to fat rather than muscle. Given the improved health that accompanies the use of ART, it is natural to expect some degree of weight gain over time.
Metabolic And Hormone Changes
HIV can raise resting energy expenditure or the number of calories burned at rest.
Low calorie intake is one of the main reasons for HIV weight loss, but REE can hasten weight loss.
Hormone levels can also influence metabolism, and HIV may alter levels of hormones needed to maintain weight and grow and repair muscles. These include:
- thyroid hormones
- testosterone
- growth hormones and factors
Those with hypogonadism may also be prone to weight loss. This occurs when the sex glands make little to no sex hormones, such as testosterone.
Low testosterone levels may result in the slowing of protein synthesis, or the creation of proteins in the body, causing a decrease in LBM.
High levels of cytokines or cell proteins may also induce inflammation as a way to incite the immune response. The body responds by making more fats and sugars but less protein, leading to reduced LBM.
Who Tends To Gain Weight With Hiv Treatment
There has been a signal from two studies that suggest the possibility of weight gain among people who have used the integrase inhibitor dolutegravir . However, those studies were done by looking back on data captured for another purpose. Such retrospective studies are useful for exploring an idea but firm conclusions cannot be drawn from them. That is why their results are only suggestive. Results from retrospective studies can be used to develop studies of a more robust statistical design.
To better explore the issue of weight gain among people using combination HIV therapy , researchers at clinics in Milan and elsewhere in Italy conducted a large observational study, assessing health-related data drawn from more than 1,000 HIV-positive people. Participants in this study used different regimens, anchored by integrase inhibitors, protease inhibitors or non-nukes. The researchers found that participants taking common combinations of HIV drugs had increases in weight and body mass index . People who were most likely to gain weight were those who were relatively thin or older prior to starting therapy.
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Cumulative Risk Of 10% Weight Loss Relative To Weight At 6 Week Postpartum In Hiv
K-M methods were used to estimate the cumulative risk of 10% weight loss in HIV-negative and HIV-positive women between 6 weeks and 2 years postpartum. All women who had weight measured within ±7 days of the scheduled date at 6 weeks and at one or more subsequent time points were included in this analysis. This analysis was not restricted to those with weight measurement within ±7 days of the scheduled follow-up visit date after the 6-week visit. Women were censored at the date on which a 10% weight loss was detected or at the date of their last weight measurement. We compared the time to weight loss between HIV groups using the Cox regression model. Univariate Cox regression models were used to identify independent risk factors for experiencing a 10% weight loss in HIV-positive women. A multivariate Cox model was constructed by stepwise selection of variables to identify influential covariates. The factors offered to the model were maternal BMI at 6 weeks, plasma CD4 cell count, plasma HIV-RNA, age, enrollment date, marital status, parity, hemoglobin, education, occupation, and household income.
A Sexually Transmitted Infection
Katie Salerno/Flickr Creative Commons
Contracting other sexually transmitted diseases can significantly increase the risk of getting HIV. For instance, some STDs like syphilis and herpes cause skin lesions that make it easier for HIV to enter the body.
STDs may also cause inflammation, which is something that is triggered by the body’s immune system. HIV preferentially infects defensive white blood cells, so when there are more of them around, it’s easier to contract HIV.
Having an STD like gonorrhea or syphilis means that you’ve engaged in unprotected sex, a key risk factor for HIV. So if you have been diagnosed with an STD, talk to your healthcare provider about how you can reduce your HIV risk.
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Importance Of Food Safety And Hygiene
The reduced immunity that HIV and AIDS can cause may make a person more susceptible to foodborne illnesses.
Germs in food and water may cause infections that last longer and are more serious in a person with impaired immunity.
Therefore, in addition to eating nutritiously, anyone with impaired immunity may wish to take extra precautions when cooking and eating.
The VA offers the following recommendations:
- Wash the hands with soap and water before and after preparing food and eating.
- Keep countertops and utensils clean.
- Rinse fresh fruits and vegetables with clean water.
- Avoid eating packaged foods if the expiration date has passed.
- Instead of thawing food at room temperature, thaw it in the microwave or refrigerator.
- Cook fish, poultry, and meat until well done, which is 165â212°F . Use a meat thermometer to check the temperature.
- Do not eat sushi or unpasteurized dairy products.
- Do not eat eggs that are not thoroughly cooked, such as those that are fried over easy or soft-boiled.
- Avoid eating leftovers that are more than 3 days old.
Water may also containbacteria, viruses, and parasites. To avoid becoming ill from contaminated water, a person may wish to buy a water filter to install in their home.
A person living with HIV or AIDS and impaired immunity may also consider using only boiled water for cooking and drinking.
Food hygiene tips
Such foods include:
To manage difficulty swallowing, individuals can take the following steps:
Obesity Among People Living With Hiv
AIDS.gov| November 19, 2009
Topics
In the U.S., as we move into the holiday season there is often increased reporting on obesity. HIV.gov asked Dr. Nancy F. Crum-Cianflone, a Research Physician with the Naval Medical Center San Diego, to provide us information on her new study of obesity in HIV-infected persons. Research has shown, HIV-infected persons are now are increasingly overweight or obese. Below is what she told us.
Obesity among HIV-infected persons: Impact of Weight on CD4 Cell Count
Since the availability of highly potent HIV medications in the mid-1990s, HIV-infected persons are less often suffering from wasting, but rather they now are increasingly overweight or obese. Prior studies have shown that obesity leads to negative health consequences in the general population including heart disease, diabetes, and certain cancers. We performed our study to evaluate if obesity could have additional health consequences among HIV-positive persons, specifically if obesity could affect their immune systems, as measured by their CD4 cell counts.
We evaluated over 1,000 HIV-infected persons as part of the US Military Natural History Study conducted at 7 HIV Clinics across the U.S. Participants of our study had known dates of HIV infection and had data on both weight measurements and immune cells over time. Statistical methods to evaluate the relationship of weights over time with changes in the CD4 counts included linear mixed effects models.
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These 9 Diseases Can Cause Weight Loss
It is very natural for your body weight to fluctuate during the year. A swing of few pounds up or down is considered normal and you need not have to worry about it. However, if you drop 5% of your body weight in less than 6 months and you do not actually know what the underlying cause might be, then it is the time you should reach your doctor and know about it. There are a lot of diseases that can make you lose weight. Read below to know more about them.
Why Do Hiv Patients Lose Weight
July 3, 2011, shiela,
Why Do HIV Patients Lose Weight?
HIV or human immunodeficiency virus is a dangerous infection because it can lead to AIDS. HIV patients often suffer from flu, fever, headache, or fatigue. By suffering these symptoms, patients might experience lower resistance and weak immune system.
If a person suffers from HIV, the infection progresses depending on the complication and the kind of infection. One thing is obvious with HIV patients. They lose weight. It is reported that people with HIV might lose 10 percent of the total weight and gaining the normal weight is difficult to do. HIV patients lose weight because their immune system is frail. They also have no appetite to eat. If a person doesnt have the appetite to eat, then not enough nutrition will be taken in by the body. Food is important to achieve good health. The nutrients from the food supply energy, protein, and vitamins needed by our blood. A person suffering from HIV doesnt usually eat complete meal so this will make them weak and might suffer from other disease. They dont have enough nutrients to combat the diseases and other infections. HIV patients may also suffer from diarrhea which is also one main reason of weight loss.
HIV patients must be considered as ordinary people who also want to live and stay happy. They must not be adjudged as dirt of the society. They need food and basic needs just what other ordinary people need.
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Nutrition And Exercise When You Have Hiv
Good nutrition and exercise can improve your health and slow the progression of your HIV infection. Eating well and working out can maintain your energy level and reduce your risk of acute infection.
You might have trouble eating if you have sores in your mouth, diarrhea, nausea, or just a poor appetite . If you have trouble eating or exercising, talk to your doctor.
If you are receiving treatment for HIV, you should follow regular dietary and exercise guidelines, which including many of the ideas below. If you condition advances, you may need to take the steps recommended here that will optimize your health.
Avoid Excessive Alcohol Or Drug Use
If you are living with HIV, there are specific risks associated with alcohol and recreational drug use that you should be aware of. Alcohol can damage the liver which the body uses to process anti-HIV drugs, so it is good to keep your alcohol consumption within the recommended limits. Heavy drinking and taking recreational drugs can also weaken your immune system, making it harder for your body to recover from infections.
Certain anti-HIV drugs can interact with recreational drugs and alcohol to cause unwanted side effects, some of which can be severe. For example, you could feel dizzy or pass out, making you potentially vulnerable. If you are worried about drug interactions, have an honest conversation with a healthcare professional and they will be able to advise you. You should also be aware that being under the influence of alcohol or other drugs may stop you taking your HIV medication properly, for example, you may forget to take a dose or too much alcohol may make you vomit. If you are sick within one hour of taking your HIV medication you should retake the dose.
If youre concerned about your alcohol or drug use, talk to a healthcare professional for advice and support.
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Predictors Of 10% Weight Loss In Hiv
In univariate analyses, BMI < 18.5 at 6 weeks, CD4 < 350 cells/l at delivery, monthly income < US$130, and schooling < 7 years were significant predictors of subsequent 10% weight loss among HIV-positive women . In the final Cox model, only CD4 at baseline, BMI at 6 weeks, and household income were retained. Lower household income was associated with a 55% higher risk of weight loss. Those with BMI < 18.5 were 45% less likely to have weight loss but those with BMI 25 had a 26% higher risk of weight loss compared to those with BMI 18.524.9.
Managing Stress And Getting Support
Looking after your mental wellbeing and emotional health is just as important as taking care of your body.
Finding out you have HIV can be a shock, and it may take you some time to adjust. Talking to your friends and family, and other people living with HIV, can really help when things get difficult. You could look for a peer mentoring or buddying service in your area.
Once you adjust to living with HIV, its a good idea to think about what you want out of life. What are your goals? Whats important to you? Maybe you want to study, travel, have a family or change career? Dont let HIV stop you, theres no reason why it should.
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To Add Protein To Your Diet
Protein-rich foods include meats, fish, beans, dairy products, and nuts. To boost the protein in your meals:
- Spread nut butter on toast, crackers, fruit, or vegetables.
- Add cottage cheese to fruit and tomatoes.
- Add canned tuna to casseroles and salads.
- Add shredded cheese to sauces, soups, omelets, baked potatoes, and vegetables.
- Eat yogurt with your cereal or fruit.
- Eat hard-boiled eggs in your salads.
- Eat beans and legumes , nuts, and seeds.
- Add diced or chopped meats to soups, salads, and sauces.
- Add dried milk powder or egg white powder to foods like scrambled eggs, casseroles, and milkshakes.
Don’t Diet Simply Watch What You Eat
Like anyone with a weight problem, adjusting what and how much you eat is the first step to weight loss. An all-too-common problem is that we try fad diets and quick loss diets that may work in the short term but do nothing to keep the weight off. An effective diet is simply one that teaches you healthy eating habits that can serve you a lifetime.
Equally important is the need to identify exactly why you eat. Ultimately people eat for many reasons besides just hunger. It’s important to think about what triggers your eating outside of mealtimes. With the help of your food diary, you can start figuring out when and why you are eating in order to identify and control those impulses.
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How Do I Keep From Losing Weight
Diet and Nutrition
Weight loss can be a common problem for people with relatively advanced stages of HIV infection, and it should be taken very seriously. It usually improves with effective antiretroviral therapy . Losing weight can be dangerous because it makes it harder for your body to fight infections and to get well after you’re sick.
People with advanced HIV often do not eat enough because:
- HIV may reduce your appetite, make food taste bad, and prevent the body from absorbing food in the right way. Some HIV medicines may also cause these symptoms .
- symptoms like a sore mouth, nausea, and vomiting make it difficult to eat
- fatigue from HIV or medicines may make it hard to prepare food and eat regularly
To keep your weight up, you will need to take in more protein and calories. What follows are ways to do that.
Working With A Nutritionist Helps
Whether you need to gain or lose weight, it’s helpful to work with a nutritionist to plan a diet that provides the number of calories and nutrients you need every day. In addition, try to exercise as much as possible, as this will help build and strengthen your muscles.
If you need to gain weight, you may be more comfortable eating six small meals throughout the day rather than three larger meals. Adding supplements, like Ensure, is one way to add concentrated calories and protein to your meal plan.
If you need to lose weight, a healthy dietone that is low in fat and high in whole grains, fruits and vegetables, plus lean protein and seafoodis a great approach that will also reduce your risk of heart disease and diabetes.
And if you are already at a healthy weight, researchers have found that a low-cholesterol diet could help you avoid the caused by some antiretroviral drugs.
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When Hiv Makes You Lose Weight
Unwanted weight loss related to HIV is less common than it once was, but it still happens. HIV itself — as well as related problems and treatments — can cause it. It’s more common in people with untreated or severe disease, an infection, or a high viral load, which is a high concentration of the virus in the blood.
When you have HIV, things that can cause you to lose weight include:
Taking Care Of Yourself When Living With Hiv
FAST FACTS
Starting antiretroviral treatment as soon as possible, and sustaining it as part of your everyday routine, is the best way of ensuring that your immune system stays strong.
Exercising regularly, eating well, getting enough rest and quality sleep are all vital to maintaining your health.
Your mental wellbeing is just as important as your physical health. Talking about your concerns with family, friends or a support group can really help.
Having HIV doesnt have to stop you living a healthy life in the way that you choose to do. With the right treatment and care, you can expect to live as long as someone who doesnt have HIV. Find out how you can look after yourself and stay healthy.
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