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Even When You're Undetectable, Diet and Exercise Is Still Important

Even When You're Undetectable, Diet and Exercise Is Still Important


Two new studies suggest that weight gain can cause additional problems for people living with HIV.

Excessive weight gain is never a good thing. Obesity strains the immune system, and two new studies show that this can create extra problems for people living with HIV. 

The first study, which was presented at the 2015 Conference on Retroviruses and Opportunistic Infections in February, studied 246 people living with HIV over the course of 48 weeks. The Prospective Evaluation of Antiretrovirals in Resource Limited Settings (PEARLS) trial documented changes in weight gain and inflammation in participants, to see if the two were linked.

What's inflammation? According to, when the immune system fights foreign invaders—viruses or bacteria (in this case, HIV)—it transports cells and fluids get called to the injury (the virus itself). 

As the body heals, the cells swell, get warm, and become sore. Since HIV chronically infects the body, cells and tissues are repeatedly healing and swelling, over-activating the immune system and causing it to become tired. Evidence suggests that this is true even when HIV is being regulated and controlled due to antiretroviral therapy. 

So even though a lab result may show a high CD4 count and low viral load, inflammation in response to HIV can cause non HIV-related damage on a cellular level—potentially leading to heart, liver, and kidney disease. The study found that those who gained excessive weight had higher degrees of inflammation, threfore putting them at increased risk for these life-threatening problems. 

Kristine Erlandson, MD and assistant professor at the University of Colorado, who headed the study, said,  “The ‘return to health’ weight gain may be beneficial in the sickest individuals. Further weight gain among those that are overweight or obese may have detrimental effects.”

A second study—the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study, which was conducted by Fred Sattler, MD and colleagues—shows that while obesity in HIV-positive people can lead to increased inflammation, the inflammation may also lead to an even greater problem: neurocognitive impairment. Neurcognitive impariment can include dementia, memory loss, and problems with language and judgement.  

When you gain weight, fat cells store excess fat. Researchers theorized that when fat cells do this, white blood cells enter the fat tissue and secrete inflammatory proteins. These proteins enter the body’s circulation and increase inflammation and immune-system activation. After studing 152 HIV-positive participants and measuring their wasit circumference, abdominal obesity, and neurocognitive function, they found that participants with greater abdominal obesity had greater neurocognitive impairment—even when 82% of them had undetectable viral loads.

The studies proved that reducing obesity is an important part of reducing inflammation and immune system activation. Once again, science proved a timeless fact: that a healthy diet and exercise helps prevent countless problems, especially for those living with HIV. The New York Department of Health offers these tips for healthy eating for HIV-positive people. If you think you are struggling with obesity, talk to your doctor about making healthy changes to your life. 

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