Association of CD4 count with anthropometric parameters and metabolic alterations in treatment naive human immunodeficiency virus infected patients


  • Arunraj C. N. Department of General Medicine, Travancore Medical College, Kollam, Kerala, India
  • Sundeep S. Department of General Medicine, Travancore Medical College, Kollam, Kerala, India



Anthropometry, CD4 count, Fasting lipid profile, Human immunodeficiency virus


Background: Body fat abnormalities and metabolic derangements are well known to occur in human immunodeficiency virus (HIV) infection. The objective of present study was to evaluate the anthropometric parameters, fasting lipid profile and fasting blood sugar in treatment naïve HIV patients and to assess any relation with CD4 count.

Methods: Anthropometric measurements, latest CD4 count were recorded from HIV patients. Blood was collected from patients for lipid profile and sugar measurements.

Results: Anthropometric parameters showed a gradual increase in waist circumference (WC), increase in waist hip ratio (WHR) and decrease in body mass index (BMI) as CD4 count declined. Fasting lipid profile showed a gradual decrease in total cholesterol, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) and increase in triglycerides (TG) and very low density lipoprotein cholesterol (VLDL-C) as CD4 count declined which were statistically highly significant (P<0.001). Compared to higher CD4 group (350-500/ mm3), the lower CD4 group (<50/mm3) showed a decrease in mean total cholesterol by 60 mg/dL, LDL-C by 76 mg/dL and HDL-C by 13 mg/dL. The increase in mean TG and VLDL-C were 154 mg/dL and 30 mg/dL respectively. Comparison of fating blood sugar (FBS) between CD4 groups showed a gradual rise in FBS as CD4 count declined.

Conclusions: As CD4 count declines, metabolic alterations occur in treatment-naïve HIV patients with substantial decrease in serum total cholesterol, HDL-C, LDL-C and an increase in TG and VLDL-C and increased incidence of impaired FBS. Morphological alteration in advanced HIV is evidenced by increased WC, WHR and decreased BMI.


Grinspoon S, Carr A. Cardiovascular risk and body-fat abnormalities in HIV-infected adults. New Eng J Med. 2005;352(1):48-62.

Krishnan S, Schouten JT, Atkinson B, Brown T, Wohl D, McComsey GA, et al. Metabolic syndrome before and after initiation of antiretroviral therapy in treatment-naive HIV-infected individuals. J Acqu Imm Defi Synd. 2012;61(3):381.

Wanke CA. Epidemiological and clinical aspects of the metabolic complications of HIV infection the fat redistribution syndrome. Aids. 1999;13(11):1287-93.

Safrin S, Grunfeld C. Fat distribution and metabolic changes in patients with HIV infection. Aids. 1999;13(18):2493-505.

Carr A. HIV lipodystrophy: risk factors, pathogenesis, diagnosis and management. Aids. 2003;17:S141-8.

Lichtenstein, Kenneth A, Ward DJ, Moorman AC, Delaney KM, Young B, et al. Clinical assessment of HIV-associated lipodystrophy in an ambulatory population. Aids. 2001;15(11):1389-8.

Reeds DN, Mittendorfer B, Patterson BW, Powderly WG, Yarasheski KE, Klein S. Alterations in lipid kinetics in men with HIV-dyslipidemia. Am J Physiol-Endocrinol Metabol. 2003;285(3):E490-7.

Devanath A, Ray S, Kumar R, Prarthana BS. A study to evaluate lipid profile in treatment naïve HIV positive patients. Indian J Clinic Biochem. 2014;29(1):45-0.

Riddler SA, Smit E, Cole SR, Li R, Chmiel JS, Dobs A, et al. Impact of HIV infection and HAART on serum lipids in men. JAMA. 2003;289(22):2978-82.

Grunfeld C, Kotler DP, Shigenaga JK, Doerrler W, Tierney A, Wang J, Circulating interpheron-alpha levels and hypertriglyceridemia in the acquired immunodeficiency syndrome. J Clin Endocrinol Metab. 1992;74:1045-8.

Grunfeld C, Pang MI, Doerrler W, Shigenaga JK, Jensen P, Feingold KR. Lipids, lipoproteins, triglyceride clearance, and cytokines in human immunodeficiency virus infection and the acquired immunodeficiency syndrome. J Clinic Endocrinol Metabol. 1992;74(5):1045-2.

Caan B, Armstrong MA, Selby JV, Sadler M, Folsom AR, Jacobs D, et al. Changes in measurements of body fat distribution accompanying weight change. Int J Obes Relat Metab Disord. 1994, 18:397-404.

Zangerle R, Sarcletti M, Gallati H, Reibnegger G, Wachter H, Fuchs D. Decreased plasma concentrations of HDL cholesterol in HIV-infected individuals are associated with immune activation. J Acqu Imm Defi Synd. 1994;7(11):1149-56.

El‐Sadr WM, Mullin CM, Carr A, Gibert C, Rappoport C, Visnegarwala F, et al. Effects of HIV disease on lipid, glucose and insulin levels: results from a large antiretroviral‐naive cohort. HIV Med. 2005;6(2):114-21.




How to Cite

C. N., A., & S., S. (2019). Association of CD4 count with anthropometric parameters and metabolic alterations in treatment naive human immunodeficiency virus infected patients. International Journal of Research in Medical Sciences, 7(6), 2062–2066.



Original Research Articles