Body Composition Among HIV-Seropositive and HIV-Seronegative Adult Patients with Pulmonary Tuberculosis in Uganda

Mupere, Ezekiel; Zalwango, Sarah; Chiunda, Allan; Okwera, Alphonse; Mugerwa, Roy; Whalen, Christopher

doi:10.1016/j.annepidem.2009.11.001

« Previous Next »Annals of Epidemiology
Volume 20, Issue 3 , Pages 210-216, March 2010

Body Composition Among HIV-Seropositive and HIV-Seronegative Adult Patients with Pulmonary Tuberculosis in Uganda

Ezekiel Mupere, MBChB, MMED, MS
- Department of Paediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH
Sarah Zalwango, MBChB
- Uganda-Case Western Reserve University Research Collaboration, Kampala
Allan Chiunda, MPH
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH
Alphonse Okwera, MBChB
- Uganda-Case Western Reserve University Research Collaboration, Kampala
Roy Mugerwa, MBChB, MMED
- Department of Internal Medicine, School of Medicine, Makerere University, Kampala, Uganda
- Uganda-Case Western Reserve University Research Collaboration, Kampala
Christopher Whalen, MD, MS
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia
- Address correspondence to: Dr. Christopher C. Whalen, Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Coverdell Center for Biomedical and Health Sciences, Athens, GA 30802. Tel: (706) 227-4736. Fax: (706) 583-0695.

Received 19 May 2009; accepted 21 November 2009.

Purpose

We determined whether human immunodeficiency virus (HIV) infection affects body cell mass and fat mass wasting among adults with pulmonary tuberculosis (PTB).

Methods

We screened 967 Ugandan adults for PTB and HIV infection in a cross-sectional study. We compared anthropometric and bioelectric impedance analysis (BIA) body composition parameters among HIV-seropositive and HIV-seronegative men and women with or without PTB by using a non-parametric test.

Results

We found that poor nutritional status associated with TB differed among men and women. Anthropometric and BIA body composition did not differ between HIV-seropositive and HIV-seronegative patients regardless of gender. Average weight group difference in men consisted of body cell mass and fat mass in equal proportions of 43%. In women, average weight group difference consisted predominantly of fat mass of 73% and body cell mass of 13%. Compared to individuals without TB, patients with TB had lower body mass index, weight, body cell mass, and fat mass regardless of gender and HIV status.

Conclusions

Gender, but not HIV status, was associated with body composition changes in TB. TB appears to be the dominant factor driving the wasting process among co-infected patients.

Key Words: Bioelectrical Impedance, Body Composition, Gender, HIV, Tuberculosis, Wasting

Selected Abbreviations and Acronyms: TB, tuberculosis, HIV, human immunodeficiency virus, BIA, bioelectrical impedance analysis, BCM, body cell mass, FM, fat mass, TNF-α, tumor necrosis factor alpha, BMI, body mass index, AIDS, acquired immunodeficiency syndrome, ELISA, enzyme-linked immunosorbent assay