Impact of tuberculosis on the body composition of HIV-infected men in Brazil.

This paper examines the impact of tuberculosis (TB) on the body composition of HIV-positive men with treatment for active TB (HIV/TB+) and HIV-infected men without TB (HIV/TB-) in Brazil. Total body water (TBW) and extracellular water (ECW) were measured by giving oral doses of deuterium oxide and sodium bromide respectively and determining the enrichment in plasma after 4 hours. Calculated from these parameters are the intracellular water (ICW) body cell mass (BCM) lean body mass (LBM) and fat mass. Age height CD4 count and HIV risk factors were similar among HIV/TB+ (n = 11) and HIV/TB- (n = 12). HIV/TB+ patients had significantly lower mean ICW (13.2 vs. 16.6 kg) and BCM (18.4 vs. 23 kg) a relative expansion of ECW (35 vs. 30 l/kg body weight nonsignificant reductions in TBW (58 vs. 62.1 kg) LBM (45.5 vs. 47.7 kg) and fat mass (12.5 vs. 14.4 kg) compared with HIV/TB- men. Nutritional status was found to be significantly worse among HIV+ patients. Malnutrition was also severe in HIV/TB+ patients which contributed to a decreased life span. Hypermetabolism appears to play a role in the wasting process of patients with HIV and TB. To improve physical function quality of life and survival among HIV-infected patients with TB optimization of nutritional status should be at the core of treatment.