Weight and body shape changes in a treatment-naive population after 6 months of nevirapine-based generic highly active antiretroviral therapy in South India

Background. The nutritional and body shape response after the initiation of highly active antiretroviral therapy ( HAART) in resource- limited environments has not been documented. In this environment, nutritional compromise is a common complication of human immunodeficiency virus ( HIV) infection. Methods. We conducted a prospective study of 190 HIV- infected patients who initiated a nevirapine- based HAART regimen. CD4(+) T cell count, body weight, body mass index, anthropometry, and bioelectrical impedance data were collected prior to initiation of therapy and after 6 months of therapy. Results. The mean age of participants was 35 years, 85% of participants were male, and 59% received stavudine as 1 of the nucleosides in their initial HAART regimen. The members of the cohort were malnourished before the initiation of therapy and had a mean body mass index of 20.1 ( calculated as weight in kilograms divided by the square of height in meters). Overall, body weight increased a mean of 2.8 kg ( range, - 12.5 to 22.5 kg), and CD4+ T cell counts increased by a mean of 140 cells/ mm(3). Patients were stratified into those who lost weight ( loss of < 1kg, 22%; n = 41), those whose weight remained stable (19%; n = 37), and those who gained weight (gain > 1kg, 59%; n = 112). Patients in all groups retained body shape symmetry and experienced no change in waist- to- hip ratio or regional body shape by anthropometry. Conclusions. The group that lost weight and the group whose weight remained stable experienced significant CD4(+) T cell count increases at 6 months. Although the majority of HIV- infected patients who received nevirapinebased HAART gained weight, there were participants who lost weight despite initiating their first HAART therapy.