{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:18:49Z","timestamp":1781522329588,"version":"3.54.1"},"reference-count":35,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T00:00:00Z","timestamp":1642464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Maintenance of the cluster of differentiation 4 (CD4) positive lymphocyte count (CD4 count) is important for human immunodeficiency virus (HIV) positive individuals. Although a higher body mass index (BMI) is shown to be associated with a higher CD4 count, BMI itself does not reflect body composition. Therefore, we examined the association of body weight, body composition and the CD4 count, and determined the optimal ranges of CD4 count associated factors in Japanese HIV positive individuals. This cross-sectional study included 338 male patients treated with antiretroviral therapy for \u226512 months. Multiple logistic regression analysis was used to identify factors significantly associated with a CD4 count of \u2265500 cells (mm3)\u22121. The cutoff values of factors for a CD4 \u2265 500 cells (mm3)\u22121 and cardiovascular disease risk were obtained by receiver operating characteristic curves. Age, body fat percentage (BF%), nadir CD4 count, duration of antiretroviral therapy (ART), years since the HIV-positive diagnosis and cholesterol intake showed significant associations with the CD4 count. The cutoff value of BF% for a CD4 \u2265 500 cells (mm3)\u22121 and lower cardiovascular disease risk were \u226525.1% and \u226425.5%, respectively. The BF%, but not the BMI, was associated with CD4 count. For the management of HIV positive individuals, 25% appears to be the optimal BF% when considering the balance between CD4 count management and cardiovascular disease risk.<\/jats:p>","DOI":"10.3390\/nu14030428","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T22:46:32Z","timestamp":1642545992000},"page":"428","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Body Fat Percentage Rather Than the BMI Is Associated with the CD4 Count among HIV Positive Japanese Individuals"],"prefix":"10.3390","volume":"14","author":[{"given":"Kumiko","family":"Shoji","sequence":"first","affiliation":[{"name":"Faculty of Nutrition, Kagawa Nutrition University, Saitama 350-0288, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michinori","family":"Shirano","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Osaka City General Hospital, Osaka 534-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Konishi","sequence":"additional","affiliation":[{"name":"Center for Health Control, Nara Medical University, Nara 634-8521, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Toyoshima","sequence":"additional","affiliation":[{"name":"Department of Nursing, Osaka City General Hospital, Osaka 534-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyuki","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Kurokawa Clinic, Osaka 557-0031, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsushi","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Osaka City General Hospital, Osaka 534-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Kasamatsu","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Osaka City General Hospital, Osaka 534-0021, Japan"},{"name":"Department of Infectious Disease, University Hospital, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Ichida","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Osaka City General Hospital, Osaka 534-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Kagawa","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition, Kagawa Nutrition University, Saitama 350-0288, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terue","family":"Kawabata","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition, Kagawa Nutrition University, Saitama 350-0288, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Ogata","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition, Kagawa Nutrition University, Saitama 350-0288, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiki","family":"Habu","sequence":"additional","affiliation":[{"name":"Graduate School of Human Life Science, Osaka City University, Osaka 558-8585, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"key":"ref_1","unstructured":"Antiretroviral Therapy Cohort Collaboration (2017). Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013, A collaborative analysis of cohort studies. Lancet HIV, 4, 349\u2013356."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Obel, N., Omland, L.H., Kronborg, G., Larsen, C.S., Pedersen, C., Pedersen, G., Sorensen, H.T., and Gerstoft, J. (2011). Impact of non-HIV and HIV risk factors on survival in HIV-infected patients on HAART: A population-based nationwide cohort study. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0022698"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/QAI.0000000000001014","article-title":"Narrowing the Gap in Life Expectancy between HIV-Infected and HIV-Uninfected Individuals with Access to Care","volume":"73","author":"Marcus","year":"2016","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/ije\/dyr164","article-title":"All-cause mortality in treated HIV-infected adults with CD4 >\/= 500\/mm3 compared with the general population: Evidence from a large European observational cohort collaboration","volume":"41","author":"Lewden","year":"2012","journal-title":"Int. J. Epidemiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/QAD.0000000000002421","article-title":"Weight gain in people living with HIV switched to dual therapy: Changes in body fat mass","volume":"34","author":"Vizcarra","year":"2020","journal-title":"AIDS"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1093\/cid\/ciz999","article-title":"Weight Gain Following Initiation of Antiretroviral Therapy: Risk Factors in Randomized Comparative Clinical Trials","volume":"71","author":"Sax","year":"2020","journal-title":"Clin. Infect Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1056\/NEJMoa1902824","article-title":"Dolutegravir plus Two Different Prodrugs of Tenofovir to Treat HIV","volume":"381","author":"Venter","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_8","first-page":"557","article-title":"A tale of 2 epidemics: The intersection between obesity and HIV infection in Philadelphia","volume":"39","author":"Amorosa","year":"2005","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1177\/2325957413488182","article-title":"Body mass index, immune status, and virological control in HIV-infected men who have sex with men","volume":"12","author":"Blashill","year":"2013","journal-title":"J. Int. Assoc. Provid. AIDS Care."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1097\/QAI.0000000000001035","article-title":"Higher Time-Updated Body Mass Index: Association with Improved CD4+ Cell Recovery on HIV Treatment","volume":"73","author":"Koethe","year":"2016","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1001\/jamaoncol.2018.5327","article-title":"Association of Body Fat and Risk of Breast Cancer in Postmenopausal Women with Normal Body Mass Index: A Secondary Analysis of a Randomized Clinical Trial and Observational Study","volume":"5","author":"Iyengar","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4433","DOI":"10.1002\/cam4.3076","article-title":"Body surface area, height, and body fat percentage as more sensitive risk factors of cancer and cardiovascular disease","volume":"9","author":"Si","year":"2020","journal-title":"Cancer Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/COH.0000000000000120","article-title":"Review: Influence of ART on HIV genetics","volume":"10","author":"Simonetti","year":"2015","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2188\/jea.JE20110075","article-title":"Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults","volume":"22","author":"Kobayashi","year":"2012","journal-title":"J. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1017\/S1368980011000504","article-title":"Comparison of relative validity of food group intakes estimated by comprehensive and brief-type self-administered diet history questionnaires against 16 d dietary records in Japanese adults","volume":"14","author":"Kobayashi","year":"2011","journal-title":"Public Health Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2174\/157340211001141111160957","article-title":"Brachial-ankle pulse wave velocity in the measurement of arterial stiffness: Recent evidence and clinical applications","volume":"10","author":"Munakata","year":"2014","journal-title":"Curr. Hypertens. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1016\/j.jacc.2019.03.009","article-title":"ACC\/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"74","author":"Arnett","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","unstructured":"Yamashina, A. (2013). Guidelines for Non-Invasive Vascular Function Test, JCS Publishing."},{"key":"ref_19","unstructured":"Committee to Evaluate Diagnostic Standards for Metabolic Syndrome (2005). The definition and Diagnostic Criteia of Metabolic Syndrome. Nihon Naika Gakkai Zasshi., 94, 188\u2013203."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Montarroyos, U.R., Miranda-Filho, D.B., Cesar, C.C., Souza, W.V., Lacerda, H.R., Albuquerque Mde, F., Aguiar, M.F., and Ximenes, R.A. (2014). Factors related to changes in CD4+ T-cell counts over time in patients living with HIV\/AIDS: A multilevel analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0084276"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"He, L., Pan, X., Dou, Z., Huang, P., Zhou, X., Peng, Z., Zheng, J., Zhang, J., Yang, J., and Xu, Y. (2016). The Factors Related to CD4+ T-Cell Recovery and Viral Suppression in Patients Who Have Low CD4+ T Cell Counts at the Initiation of HAART: A Retrospective Study of the National HIV Treatment Sub-Database of Zhejiang Province, China, 2014. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0148915"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Means, A.R., Risher, K.A., Ujeneza, E.L., Maposa, I., Nondi, J., and Bellan, S.E. (2016). Impact of Age and Sex on CD4+ Cell Count Trajectories following Treatment Initiation: An Analysis of the Tanzanian HIV Treatment Database. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0164148"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1742-6405-8-2","article-title":"Long-term CD4+ lymphocyte response following HAART initiation in a U.S. Military prospective cohort","volume":"8","author":"Lifson","year":"2011","journal-title":"AIDS Res. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1093\/cid\/cir606","article-title":"An optimal body mass index range associated with improved immune reconstitution among HIV-infected adults initiating antiretroviral therapy","volume":"53","author":"Koethe","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2249","DOI":"10.1007\/s10461-014-0805-0","article-title":"Longitudinal association between BMI at diagnosis and HIV disease progression","volume":"18","author":"Johnson","year":"2014","journal-title":"AIDS Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/j.1749-6632.2008.03973.x","article-title":"Leptin action in the thymus","volume":"1153","author":"Velloso","year":"2009","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.bbrc.2010.03.019","article-title":"Preferential effects of leptin on CD4 T cells in central and peripheral immune system are critically linked to the expression of leptin receptor","volume":"394","author":"Kim","year":"2010","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1093\/infdis\/jiw146","article-title":"T-Cell Activation Independently Associates with Immune Senescence in HIV-Infected Recipients of Long-term Antiretroviral Treatment","volume":"214","author":"Wit","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Gutierrez, J., Albuquerque, A.L.A., and Falzon, L. (2017). HIV infection as vascular risk: A systematic review of the literature and meta-analysis. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0176686"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1093\/infdis\/jix340","article-title":"The Role of Human Immunodeficiency Virus-Associated Vasculopathy in the Etiology of Stroke","volume":"216","author":"Benjamin","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_31","first-page":"289","article-title":"Examination of Body Composition Analysis Factors Influencing Branchial-ankle Pulse Wave Velocity in Workers","volume":"60","author":"Hiroshige","year":"2012","journal-title":"JJOMT"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1079\/BJN20061745","article-title":"Differences in the relationship between BMI and percentage body fat between Japanese and Australian-Caucasian young men","volume":"95","author":"Kagawa","year":"2006","journal-title":"Br. J. Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1046\/j.1467-789X.2002.00065.x","article-title":"Asians are different from Caucasians and from each other in their body mass index\/body fat per cent relationship","volume":"3","author":"Deurenberg","year":"2002","journal-title":"Obes Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1590\/S0036-46652015000200002","article-title":"Discordance between body mass index and anthropometric measurements among HIV-1-infected patients on antiretroviral therapy and with lipoatrophy\/lipohypertrophy syndrome","volume":"57","author":"Soares","year":"2015","journal-title":"Rev. Inst. Med. Trop. Sao Paulo"},{"key":"ref_35","unstructured":"(2021, December 20). The Ministry of Health, Labor and Welfare the AIDS Outbreak Trends Survey. Available online: https:\/\/api-net.jfap.or.jp\/status\/japan\/nenpo.html."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/3\/428\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:03:39Z","timestamp":1760133819000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/3\/428"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,18]]},"references-count":35,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["nu14030428"],"URL":"https:\/\/doi.org\/10.3390\/nu14030428","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,18]]}}}