With HIV medicines (antiretroviral therapy), physical health of people living with HIV is generally restored. However, health problems unrelated to gross immunodeficiency may emerge as a result of direct viral effects with ongoing inflammation and immune activation, antiretroviral therapy, as well as host factors. The main medical conditions are metabolic and cardiovascular diseases. The monitoring of body weight and fat, cardiovascular disease risk, kidney function and bone health can help achieve early diagnosis of these metabolic conditions, and prevent their occurrence.
Download CU+ Apps for personal health assessment.
Body weight and fat
Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Body mass index (BMI) is a simple index commonly used to classify overweight and obesity in adults. Raised BMI is a major risk factor for cardiovascular diseases, diabetes, musculoskeletal disorders and some cancers. Another way to estimate your potential disease risk is to measure your waist circumference. Excessive abdominal fat may place you at greater risk for developing obesity-related conditions. Total body fat percentage is another measure of assessing the amount of fat in the body.
You can reduce body weight by:
- limit energy intake from total fats and sugars
- increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts; and
- engage in regular physical activity (150 minutes spread through the week for adults)
BMI
| BMI | Meaning |
|---|---|
| <18.5 | Underweight |
| 18.5 – 23 | Normal range |
| >23 – 27 | Overweight |
| >27 | Obese |
Reference: Consultation WHOE. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63.
Waist Circumference
| Gender | Reading | Meaning |
|---|---|---|
| Men | ≥90cm | You have central obesity |
| <90cm | You don't have central obesity | |
| Women | ≥80cm | You have central obesity |
| <80cm | You don't have central obesity |
Reference: Alberti KG, Zimmet P, Shaw J. The metabolic syndrome – a new worldwide definition. Lancet 2005; 366 (9491): 1059–1062.
Total Body Fat Percentage
| Gender | Reading | Meaning |
|---|---|---|
| Men | 25% | You have obesity |
| ≤25% | You do not have obesity | |
| Women | >32% | You have obesity |
| ≤32% | You don't have obesity |
Heart disease risk
Studies have shown that people living with HIV has higher risk of atherosclerotic cardiovascular diseases (ASCVD) like myocardial infarction. This is related to ageing, family history, smoking, conventional risk factors (diabetes, hypertension and hyperlipidaemia), as well as HIV and its treatment.
Your risk of having atherosclerotic cardiovascular disease (e.g. heart attack and stroke) in the next 10 years is:
| Range | Risk category |
|---|---|
| <5% | Low risk |
| 5% to 7.4% | Borderline risk |
| 7.5% to 19.9% | Intermediate risk |
| ≥20% | High risk |
Kidney function
The main function of the kidneys is to filter harmful waste from the body. Poorly controlled HIV infection can damage the kidneys. High blood pressure and diabetes are other common causes of kidney disease unrelated to HIV. Other causes of kidney problems are adverse effects of some HIV medicines and concurrent hepatitis C infection.
Our kidney function is reflected by measuring the estimated glomerular filtration rate (eGFR).
| GFR (ml/min/1.73m2) | Kidney function |
|---|---|
| ≥ 90 | Normal |
| 60-89 | Mildly decreased |
| 45-59 | Mildly to moderately decreased |
| 30-44 | Moderately to severely decreased |
| 15-29 | Severely decreased |
| <15 | Kidney failure |
Bone health
Osteoporosis means porous bone. It is a disease in which the density and quality of bone are reduced. As bones become more porous and fragile, the risk of fracture is greatly increased. Adequate calcium and vitamin D intake, as well as weight-bearing exercise and resistance training are good for bone health.
| T-score | Meaning |
|---|---|
| ≥ -1 | Normal |
| Between -1 and -2.5 | Osteopenia (low bone mass) |
| ≤ -2.5 | Osteoporosis |
Download CU+ Apps for personal health assessment.