Area HIV Patients Mirror National Study

Oct 05, 09:04 AM

Current Headlines: By Rose Ybarra, The Beaumont Enterprise, Texas

Oct. 5--Yvonne Thomas avoids fried foods and she walks regularly for exercise.

And yet, the 50-year old Beaumont resident has gained 85 pounds since she tested positive for HIV in June 2003.

"I used to fry a lot but I've changed my way of eating," she said. "I boil, broil and bake now, but every time I get on the scale, the numbers are up. You think you're doing the right thing but it doesn't make a difference. It's frustrating."

Early in the AIDS epidemic, people infected with the virus often lost a dangerous amount of weight, at times looking gaunt and ghostly.

Today, many who have HIV, but not full-blown AIDS, are struggling with obesity, which has overtaken "wasting syndrome" as the top concern.

AIDS researchers and advocacy groups say the waistlines of HIV patients are growing right along with the girths of uninfected Americans as the disease shifts from a death sentence to a chronic condition.

Exact numbers are hard to pin down. But new research suggests that almost two-thirds of the HIV population might be overweight or obese, mirroring the U.S. population.

Infectious disease specialist Dr. Michael Thomas of Beaumont, no relation to Yvonne Thomas, said the new research also rings true in Southeast Texas and one patient in particular came to mind.

The patient weighed 130 pounds at their first meeting in 1999. His lab tests were bad at the time and he needed to gain a few pounds.

"He weighs 265 pounds now," the doctor said. "He overshot. There's this notion in the community that when you have HIV, you need to eat and eat but that's not true."

About a million people in the United States are living with HIV or AIDS, federal statistics show. At the height of the epidemic, many had wasting syndrome, the uncontrollable loss of 10 percent of body weight along with other symptoms like fever or diarrhea.

Thomas said the average HIV/AIDS patient of today is not like the 1980s version.

"Initially, it was called 'slim disease' because there was no care and the patients were all skeletons, emaciated and wasted away," he said.

A turning point in the AIDS crisis came with advances in modern medicine. Powerful drugs that keep the virus at bay also boost the body's immune system. The result is that more HIV patients are living much longer than their counterparts two decades ago.

"The life expectancy of an HIV-positive person is not much different than a non-HIV positive person," Thomas said.

Dr. Nancy Crum-Cianflone of TriService AIDS Clinical Consortium in San Diego became interested in the problem after noticing her patients were steadily getting fat. She decided to study how common obesity was in the HIV population.

She and her colleagues pored through medical records of 663 patients with HIV at U.S. Navy hospitals in San Diego and Bethesda, Md. Researchers analyzed medication records, duration of HIV infection and whether patients had a history of diabetes or high blood pressure.

Sixty-three percent in the study were overweight or obese. Only 3 percent were underweight and none were considered to be wasted. Among those with full-blown AIDS, about 30 percent were overweight or obese.

Stacey Williams, an AIDS certified registered nurse with the Early Intervention Virology Clinic in Beaumont, part of the Triangle AIDS Network, said she hasn't seen the significant weight gains seen in the study.

"I think what we're seeing is that we are catching the disease earlier, way before they are wasting," she said. "We are treating people earlier than before, so versus the numbers 20 years ago, yes, the patients are heavier."

Williams added because more of the general population is overweight, new HIV/AIDS cases will tend to include more overweight people.

"There's a national increase of obesity across the board," she said. "And (HIV/AIDS) is no different."

Researchers did not find a connection between the AIDS drugs and excess weight.

Thomas disagreed with that aspect of the study. He feels today's HIV/AIDS antiretroviral medications do contribute to weight gain.

He said many HIV/AIDS experience lipodystrophy, a condition that is characterized by changes in body shape and metabolism. Among the possible changes is the accumulation of fat.

Yvonne Thomas doesn't know why she can't keep her weight down, but no matter the reason, the extra pounds are affecting her quality of life. Though she loves to go out and dance, it's too tiring now.

"I was always a big girl but never this big," she said. "I can't do all the thintgs I want to all the time."

Amy Shows, a professor of nutrition at Lamar University and registered dietitian, said there is not one general diet good for all HIV/AIDS patients.

"It depends on where someone is with the disease," said Shows.

Shows said she recommends people with compromised immune systems, such as HIV/AIDS patients, avoid raw and undercooked foods because of the increased risk of foodborne illness.

"Even if they are overweight," she said. "A lot of times when people want to lose weight, they think, 'I'll eat a salad,' and that can be effective but it can be a concern for anyone with a compromised immune system."

Thomas said the diseases brought on by obesity can become a greater concern for patients than the HIV/AIDS.

"The HIV might be controlled but they can still have rampant diabetes and high cholesterol," he said. "Then heart attacks and strokes become a greater threat."

The doctor said it's time for society to rewrite the rules about weight and HIV/AIDS.

"No matter what disease you have, there's no benefit to being overweight," he said.

Associated Press science writer Alicia Chang contributed to this report.

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