Body composition evaluation by dexa in follow up HIV patients treated with HAART

1693 Objectives Body fat changes and bone mineral density loss may occur, despite virological control, in HIV pts on HAART, mainly with protease inhibitors (PI), with still unclear pathogenetic mechanism. We further evaluated quantitative body composition in a longitudinal study of HIV pts receiving HAART. Methods We studied 61 HIV pts with stable clinical conditions, 34 males and 27 females with mean basal age of 39±6 yrs; 24 pts were CDC stage A, 19 stage B and 16 stage C, 55 were treated with HAART, 6 were naive. In all pts, at basaline and after 5 yrs of follow up, we measured by DEXA total weight (TW), total fat mass (TFM), total lean mass (TLM) and total body bone mineral density (TBD) Results At basaline, mean CD4 cell count was 590 ±2 cells/mm3 and HIV RNA 4.84±5.44 log10 copies/ml and the values remained stable during follow up and HAART was PI-based in 34 pts and non-PI-based in 27.TW had mean basal values of 64656±12083g with reduction (63025±14696g; -2.5%) in the follow up, but not significantly. TFM and TLM basal values (13472±5196, 49059±9988g, respectively) decreased during follow up although not significantly (12990±5734g, -3.7% and 48065±11704g, -2.0%). However, TBD values had significant reduction (-1.9%) than baseline (1.04±0.10 vs 1,06±0.10g/cm2, p=0.009), but only PI treated pts showed TBD significant decrease (1.034±0.106 vs 1.057±0.102g/cm2, p=0.006) not those without PI (1.046±0.100 vs 1.054±0.089 g/cm2, p=0.439). Both PI and not PI groups had no statistical difference comparing TW, TFM, TLM reductions. Conclusions Unintentional TW loss seems to occur during follow up in HIV pts on HAART. In our cases, both TFM and TLM reductions were concomitantly with significant TBD decrease even more in PI treated pts. These findings suggest that frailty phenotype associated factors should be further investigated in HIV pts in order to reduce non-AIDS related morbidity and mortality in this prematurely aging population.