Update: Resting Energy Expenditure in the HAART Era
HIV infection in the HAART Era is often accompanied by nutritional complications, including rapid weight loss and weight gain. Changes in weight are directly related to shifts in energy balance. Understanding the interplay between dietary intake and energy utilization is important for investigating the factors contributing to a person's weight shifts. Total energy use includes resting metabolic rate, or resting energy expenditure (REE), and voluntary activity, both of which are commonly abnormal in persons with HIV infection. There is now evidence that both the level of viral load and the use of HAART affect REE. The role of energy expenditure in lipodystrophy is unknown but is an area of research interest. The current understanding of energy balance in persons with HIV infection is explained here for the health care provider.
Most primary care physicians and infectious disease specialists are not well versed in concepts of energy expenditure. Yet, studies of metabolic rate frequently find their way into the HIV literature. The presence of HIV infection has been implicated in increasing resting energy expenditure (REE), as have opportunistic infections. A relationship between viral load and energy expenditure has been confirmed recently. Moreover, the possibility of a direct effect of HAART on energy expenditure has been raised. Understanding this component of energy balance is essential for comprehending weight gain and weight loss in the HIV-seropositive population.
HIV infection in the HAART Era is often accompanied by nutritional complications, including rapid weight loss and weight gain. Changes in weight are directly related to shifts in energy balance. Understanding the interplay between dietary intake and energy utilization is important for investigating the factors contributing to a person's weight shifts. Total energy use includes resting metabolic rate, or resting energy expenditure (REE), and voluntary activity, both of which are commonly abnormal in persons with HIV infection. There is now evidence that both the level of viral load and the use of HAART affect REE. The role of energy expenditure in lipodystrophy is unknown but is an area of research interest. The current understanding of energy balance in persons with HIV infection is explained here for the health care provider.
Most primary care physicians and infectious disease specialists are not well versed in concepts of energy expenditure. Yet, studies of metabolic rate frequently find their way into the HIV literature. The presence of HIV infection has been implicated in increasing resting energy expenditure (REE), as have opportunistic infections. A relationship between viral load and energy expenditure has been confirmed recently. Moreover, the possibility of a direct effect of HAART on energy expenditure has been raised. Understanding this component of energy balance is essential for comprehending weight gain and weight loss in the HIV-seropositive population.
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