TREATMENTS FOR WASTING IN PATIENTS WITH THE ACQUIRED IMMUNO DEFICIENCY SYNDROME

English Version

WASTING was an early identifying characteristic of human immuno deficiency virus (HIV) infection, originally termed “slim disease” in Africa. As defined by the Centers for Disease Control and Prevention (CDC), wasting in atients with the acquired immuno deficiency syndrome (AIDS) is the involuntary loss of more than 10 percent of base-line body weight in combination with diarrhea, weakness, or fever. Wasting is considered an AIDS-defining condition. However, there is considerable controversy about the appropriate definition of AIDS wasting (whether it should be defined as the loss of 5 or 10 percent of usual weight) and whether changes in body composition, rather than weight alone, better define the syndrome. For example, the initial characterization of AIDS wasting involved the disproportionate loss of lean body mass and muscle wasting in men (Fig. 1). Recent data suggest that women may lose relatively more fat than lean body mass and that changes in body composition may be related to the initial amount of body fat before weight loss in HIV infected patients.

Potential mechanisms of AIDS wasting include increased energy expenditure, decreased energy intake, inefficient use of energy substrate, and hormonal factors. AIDS wasting can lead to diminished functional capacity and death. Substantial progress has been made in the development of successful treatments for both men and women with AIDS wasting (Table 1).


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