Background:  Metabolic and morphologic derangements are frequent complications of HIV disease and its treatment, and may be associated with chronic inflammation. Some of these abnormalities, including changes in body fat distribution, are also associated with an increased risk for cardiovascular disease (CVD). High sensitivity C-reactive protein (hs-CRP), a sensitive marker of inflammation, is a powerful predictor of CVD, however the association of hs-CRP with body composition changes in HIV infection has not been described. We examined the association of hs-CRP with body shape changes as measured by anthropometry and dual energy x-ray absorptiometry (DEXA) in an HIV-infected cohort.

Methods:  We evaluated 422 Nutrition for Healthy Living (NFHL) participants stratified by gender (28% female, 50% non-white). The longitudinal association of mean hs-CRP with body composition measured 6 months later was analyzed using generalized estimating equations (GEE) for repeated measures controlled for race and smoking.

Results:  Mean age was 43 (±7) years for women and 46 (± 7) years for men; 62% of women and 77% of men were on HAART; 64% of woman and 44% of men were current smokers. Hs-CRP was 3.47 (±4.85) in women and 3.08 (±5.3) in men (p = 0.124). Body mass index, triceps skinfold, fat mass by DEXA were significantly higher in women than in men (p <0.05). In women, hs-CRP was positively associated with limb, trunk, and whole body lean mass as measured by DEXA (p = 0.003, 0.04, and 0.004, respectively). In men, there was a trend for hs-CRP to positively predict DEXA-measured trunk and whole body lean mass (p = 0.07, 0.09, respectively), but not limb lean tissue. There was no association with fat mass in men or women. Hs-CRP positively predicted triceps skinfold in men (p = 0.01), but not in women. Hs-CRP was not associated with other anthropometric measures in both genders. Adjustment for smoking and race did not significantly alter these associations. There was no association of hs-CRP with CD4 count, HIV viral load, glucose, or insulin.

Conclusions:  Hs-CRP was associated with lean body mass as measured by DEXA in HIV-infected women, but not in men. Hs-CRP has been shown to be an independent predictor of mortality in HIV-infected women. Performing hs-CRP measurements in female patients with HIV may assist in the identification of patients in whom more aggressive assessment of metabolic, body shape abnormalities and CVD risk might be of benefit.