Abstract
Maintenance of the cluster of differentiation 4 (CD4) positive lymphocyte count (CD4 count) is important for human immunodeficiency virus (HIV) positive individuals. Although a higher body mass index (BMI) is shown to be associated with a higher CD4 count, BMI itself does not reflect body composition. Therefore, we examined the association of body weight, body composition and the CD4 count, and determined the optimal ranges of CD4 count associated factors in Japanese HIV positive individuals. This cross-sectional study included 338 male patients treated with antiretroviral therapy for ≥12 months. Multiple logistic regression analysis was used to identify factors significantly associated with a CD4 count of ≥500 cells (mm3)−1. The cutoff values of factors for a CD4 ≥ 500 cells (mm3)−1 and cardiovascular disease risk were obtained by receiver operating characteristic curves. Age, body fat percentage (BF%), nadir CD4 count, duration of antiretroviral therapy (ART), years since the HIV-positive diagnosis and cholesterol intake showed significant associations with the CD4 count. The cutoff value of BF% for a CD4 ≥ 500 cells (mm3)−1 and lower cardiovascular disease risk were ≥25.1% and ≤25.5%, respectively. The BF%, but not the BMI, was associated with CD4 count. For the management of HIV positive individuals, 25% appears to be the optimal BF% when considering the balance between CD4 count management and cardiovascular disease risk.
Highlights
Introduction iationsWith the development of antiretroviral therapy (ART), the mortality rate of human immunodeficiency virus (HIV)-positive individuals has drastically improved [1]
RNA levels, which can be controlled relatively well with ART, the control of cluster of differentiation 4 (CD4) count is important for HIV positive individuals
Factors that were significantly associated with a CD4 count of ≥500 cells−1 included the age (≤45.5 years), body fat (BF)% (≥25.1%), nadir CD4 count (≥137.5 cells−1 ), duration of ART (≥28.5 months), years since the HIV-positive diagnosis (≥5.5 years) and cholesterol intake (≤265.3 mg 1000 kcal−1 )
Summary
With the development of antiretroviral therapy (ART), the mortality rate of human immunodeficiency virus (HIV)-positive individuals has drastically improved [1]. It was shown that the mortality rate did not differ significantly between healthy individuals and HIV-positive men with a CD4 positive lymphocyte count (CD4 count) of 500/mm or higher and no risk factors [4]. This indicates that in addition to the HIV. RNA levels, which can be controlled relatively well with ART, the control of CD4 count is important for HIV positive individuals. There was an increasing number of reports showing that weight and body fat (BF) increase with ART, with integrase strand transfer inhibitors (INSTIs) [5,6,7].
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