Jacobson et al identified risk factors for acute weight loss in patients with human immunodeficiency virus (HIV) disease. This can help identify patients who may require additional nutritional support or interventions. The authors are from Tufts and Harvard Universities in Boston.


Criteria for weight loss: >= 5% of usual weight (based on telephone interviews done with median interval of 36 days)


Risk factors increasing the risk of acute weight loss:

(1) oral symptoms (oral sores, oral pain, thrush, other)

(2) swallowing difficulties


Factors reducing the risk for acute weight loss:

(1) BOTH receiving highly active antiretroviral therapy (HAART) AND no diarrhea

(2) being a man who has sex with men

(3) serum albumin level > 4 g/dL (see comment)



• The reporting of how albumin levels impact weight loss makes usage difficult. The mean initial serum albumin levels in the patients was 4.2 g/dL +/- 0.4. The relative risk was 0.7 for each 1 g/dL increase in serum albumin. A serum albumin < 3.2 g/dL is in the range of hypoalbuminemia, which is a measure of malnutrition. The effect of a low albumin might have been easier to use as an algorithm.


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