Increasing Risk of 5% or Greater Unintentional Weight Loss in a Cohort of HIV-Infected Patients, 1995 to 2003
Harvard University, Cambridge, Massachusetts, United StatesJAIDS Journal of Acquired Immune Deficiency Syndromes (Impact Factor: 4.56). 09/2005; 40(1):70-6. DOI: 10.1097/01.qai.0000159627.54149.2e
Although the incidence of most AIDS-defining opportunistic infections, including HIV wasting syndrome, has dramatically decreased since the introduction of highly active antiretroviral therapy (HAART), previous studies have shown that weight loss and wasting are still common in HIV-infected persons. We examined the 6-month risk and determinants of > or =5% weight loss during the period when the use of combination antiretroviral therapy and HAART was commonplace among 713 participants enrolled in the Nutrition for Healthy Living cohort in Boston, Massachusetts between 1995 and 2003. There was a significant 50% increase in the 6-month risk of > or =5% weight loss in the later HAART years (1998-2003) compared with the early HAART years (1995-1997) among most of the participants who reported they were not trying to lose weight (P = 0.002). In addition to calendar time, several other variables were significantly independently associated with risk of > or =5% weight loss, including use of injection drugs; living below the federal poverty level; higher body mass index (BMI; > or =25 kg/m(2)); lower CD4 cell count; higher HIV viral load; and presence of diarrhea, nausea, or fever. The characteristics of weight loss in the later HAART years did not differ from the early HAART years with respect to initial body composition (eg, weight, BMI, triceps skinfold thickness) or changes in body composition during the periods of weight loss. In summary, we have found that the risk of > or =5% unintentional weight loss over 6-month intervals is on the rise in our cohort of HIV-infected participants, despite better control of HIV infection in recent years. Although we still do not know the exact cause of this increase, the fact that it exists indicates the need for clinicians who take care of HIV-infected patients to continue to pay attention to weight loss among particular segments of their patient population. This is particularly important because recent studies have shown that even a 5% weight loss in 6 months markedly increases the risk of death.
Article: HIV Patients and Weight Loss
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ABSTRACT: A basic understanding of the thermal and crystallisation processes involved in phase-change recording is required to accelerate research on development of high data rate and high-capacity formats, such as the digital video recording (DVR) system (T. Narahara et al, Jpn. J. Appl. Phys., vol. 39, no. 2B, pp. 912-919, 2000; M.J. Dekker et al, Proc. SPIE vol. 4090, pp. 28-35, 2000) and dual-layer DVR format. A simulation tool to predict formation and erasure of amorphous marks has proven to be helpful. Last year, we presented modelling results for mark formation and erasure in dual-layer DVR stacks based on fast-growth phase-change materials (E.R. Meinders et al, Proc. SPIE vol. 4342, pp. 64-75, 2001). One of the main challenges of such a simulation tool is accurate determination of the input parameters, such as the thermal properties of the disc and the crystallisation kinetics. We have developed the melt-threshold method to determine the thermal properties from threshold power measurements and modelling (E.R. Meinders et al, Jpn. J. Appl. Phys. vol. 40, pp. 1558-1564, 2001). In this paper, we present results of the experimentally determined crystallisation kinetics used in the mark formation and erasure model. We discuss modelling results and compare the predicted mark shapes with transmission electron microscopy (TEM) measurements.
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