Body composition changes during lactation in HIV-infected and HIV-uninfected South African women

Background: The nutritional consequences of HIV infection in lactating women are unknown. Objective: To measure the body composition of South African lactating women in relation to HIV status. Methods: Fat-free mass (FFM) and fat mass (FM) using bioimpedance spectrometry (BIS) and anthropometric measurements were obtained at 8 and 24 weeks postpartum in 92 HIV-infected (HlVpos) and 50 HIV-uninfected (HIVneg) lactating mothers. Results: At 8 weeks, HIVpos and HIVneg mothers were not significantly different in height (159.7 vs. 158.9 cm), weight (62.7 vs. 63.9 kg), body mass index (BMI; 24.6 vs. 25.3 kg/m(2)), FFM (40.7 vs. 42.8 kg), or FM (21.6 vs. 22.0 kg), respectively. In HIVpos women, the median CD4(+) count was 621 (range: 101-1585) cells/mu L; 95% had CD4(+) counts > 200 cells/mu L. Between 8 and 24 weeks, HIVpos mothers had a mean weight loss of 1.4 kg in contrast to a 0.4-kg weight gain in HIVneg mothers (P < 0.01). There were no significant group differences with regard to change in FFM (0.3 vs. 0.1 kg; P = 0.9) and FM (- 1.5 vs. -0.3 kg; P = 0.2). Conclusion: HlVpos South African breast-feeding mothers without severe immune suppression lost weight and subcutaneous fat between 8 and 24 weeks postpartum, whereas HIVneg mothers gained weight. FFM was maintained postpartum in HIVpos and HIVneg mothers.