Anthropometric Profile of Patients Living With Hiv/Aids in Lviv Region

Abstract

The body of PLHIV undergoes profound anthropometric changes in adipose tissue distribution, which develop under the influence of pathogenetic mechanisms caused by HIV and due to impaired side effects of ART. ART leads to the development of lipoatrophy / lipohypertrophy syndrome. This phenomenon is described as a syndrome characterized by the loss and/or accumulation of fat and has three types: lipohypertrophy, lipoatrophy, and mixed lipodystrophy. These changes in body shape are very important to determine because they are associated with negative disease dynamics and high mortality. Therefore, it is extremely important to detect this syndrome early to ensure a better quality of life for this population, as the clinical approach is not easy. Potential approaches to treatment, including lifestyle changes, with adequate eating habits, exercise, and some medical interventions, showed little effect in PLHIV. In this case can be effectively reduced through exercise. Despite the existence of established exercise guidelines, the effective dosage of exercise to reduce HRT requires verification.
 The aim. Study the anthropometric parameters in PLHIV and establish the relationship between the parameters and the degree of viral load (HV) of HIV, the level of CD4 + T-lymphocytes.
 Materials and methods: 60 patients aged 18 to 60 years were examined. We used standard methods of measuring the following anthropometric indicators: body weight, height, chest circumference, waist and hips. The waist-to-thigh ratio index was also determined. The calculation of the body mass index was performed according to the standard formula by dividing body weight (in kilograms) by the square of height (in square meters). The indicator 18.5-24.9 is considered normal. The level of CD4 + T-lymphocytes was determined by flow cytofluorometry. The viral load of HIV was determined by real-time PCR. Statistical indicators, median, Pearson's coefficient, Student's t-test, were calculated using Microsoft Excel 2016.
 Results. The average waist circumference was smaller in both the men of the experimental group (74.5 ± 10.3 cm) and the women of the experimental group (61.9 ± 11.0 cm) than in the control groups of men (90.4 ± 9.4 cm) and women (67.5 ± 7.3 cm (p <0.05)). The average ratio of waist circumference to hip circumference in the group of male PLHIV was 0.94 ± 0.08 cm in the control group of men - 0.97 ± 0.8 cm (p <0.05). In the group of female PLHIV, this indicator reached 0.86 ± 0.1 cm, and in the control group - 0.75 ± 0.3 cm (p <0.05). The mean forearm circumference was lower in the two research groups. However, in men with HIV (18.5 ± 3.1 cm) this figure was lower than in women with HIV (19.9 ± 3.9 cm (p <0.05)). Also, the circumference of the tibia was larger in female PLHIV (26.9 ± 3.9 cm) than in male PLHIV (20.8 ± 3.8 cm (p <0.05)).
 Conclusions. PLHIV at the stage of AIDS leads to the recomposition of the body. It is manifested by a decrease in BMI, waist circumference, hip, mid-upper arm, and calf, which indicates lipodystrophy. Increase in the index of the waist circumference to hip circumference ratio indicates a probable redistribution of adipose tissue. BMI cannot be used as an accurate method to determine obesity or lipodystrophy. A positive correlation was found between the value of the anthropometric profile and the level of viral load and CD4 + T-lymphocytes. Early administration of ART and dosed exercise is likely to have a positive effect on the body structure of PLHIV in the AIDS stage, although this requires further research.