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HIV wasting syndrome: treatment update
D L Balog1, M E Epstein, M I Amodio-Groton
1Montefiore Medical Center, Bronx, NY 10467, USA.
The Annals of Pharmacotherapy
|April 30, 1998
Summary
HIV wasting syndrome, characterized by lean body mass loss, impacts advanced HIV infection. Management involves appetite stimulants, cytokine inhibitors, and anabolic agents to improve outcomes.
Area of Science:
- Immunology
- Infectious Diseases
- Metabolic Disorders
Background:
- HIV wasting syndrome is a common, severe complication of advanced HIV infection.
- It involves preferential loss of lean body mass, distinct from general malnutrition.
- Multiple factors contribute, including reduced intake, malabsorption, altered metabolism, and cytokine dysregulation.
Purpose of the Study:
- To review the pathophysiology of HIV wasting syndrome.
- To outline current and emerging treatment strategies for HIV wasting syndrome.
Main Methods:
- Comprehensive literature search of MEDLINE (1987-1997).
- Inclusion of bibliographies from reviewed articles.
Main Results:
- HIV wasting involves preferential lean body mass loss with preserved fat.
- Etiology is multifactorial: decreased caloric intake, malabsorption, altered energy expenditure, cytokine effects, endocrine dysfunction.
- Pharmacologic options include appetite stimulants, cytokine inhibitors, and anabolic agents.
Conclusions:
- Untreated HIV wasting leads to significant morbidity and mortality.
- Therapeutic approaches encompass appetite stimulants, cytokine inhibitors, and growth-promoting agents.
- Treatment selection depends on the cause of weight loss, side effects, and cost.