Background:  There are few data on the nutritional response of patients recently initiating antiretroviral therapy in India.

Methods:  Prospective cohort study at YRG CARE, in Chennai, South India, of patients recently initiating NNRTI based HAART in December 2001. Weight and body shape was measured at 6 months from initiation of ART. Anthropometric measures were obtained in triplicate by one trained observer.  Data presented are the mean of the 3 measures.  Bioelectric impedance analysis was performed on the RJL Systems Quantum II and calculated with Cyprus Body Composition Analysis 1.2 software.

Results:  At baseline, 107 subjects (mean age 35; 87% male) had measurements and at a mean of 188 days;  22 (21%) patients lost weight (a mean of 3.05 kg from a baseline body mass index of 23.48 kg/m², 31 (29%) were weight stable (+1 kg) with a body mass index of 20.07 kg/m² and 54 (50%) patients gained weight (a mean of 4.4 kg from a body mass index of 19.71 kg/m². In the weight loss group, body mass index decreased 1 kg/m², body cell mass  decreased 0.5 kg and fat decreased 1.3 kg. Triceps and suprailiac skin-folds decreased 0.5 and 0.1 mm respectively. Midarm circumference decreased 0.5 cm. In the weight stable group, midarm circumference and body cell mass showed no change, while fat increased 1.02 kg. Triceps and suprailiac skin-folds increased 2.07, 1.73, and 2.89 mm, respectively.  In the weight gain group, body mass index increased 1.3 kg/m², body cell mass increased 1.5 kg and fat increased 2.05 kg. Triceps and suprailiac skin-folds increased 3.5 mm. Midarm circumference increased by 1.3 cm. All of these differences were significant when compared to baseline

Conclusions:  Only 50% of the subjects gained weight with the initiation of ART, likely related to improved health status. The weight loss group lost more fat than body cell mass, suggestive of fat atrophy.

Keywords: Body shape changes; Weight; Antiretroviral therapy