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According to ''Medical Subject Headings'', '''HIV wasting syndrome''', also called '''AIDS wasting syndrome''', is defined by involuntary weight loss of greater than 10 percent associated with intermittent or constant fever and chronic diarrhea or fatigue for more than 30 days in the absence of a defined cause other than [[human immunodeficiency virus]] infection. A constant feature is major muscle wasting with scattered myofiber degeneration. A variety of etiologies, which vary among patients, contributes to this syndrome.
According to ''Medical Subject Headings'', '''HIV wasting syndrome''', also called '''AIDS wasting syndrome''', is a complication of [[Acquired Immune Deficiency Syndrome]] that is defined as "involuntary weight loss of greater than 10 percent associated with intermittent or constant fever and chronic diarrhea or fatigue for more than 30 days in the absence of a defined cause other than [[human immunodeficiency virus]] infection. A constant feature is major muscle wasting with scattered myofiber degeneration. A variety of etiologies, which vary among patients, contributes to this syndrome."<ref>{{MeSH}}</ref><ref name="pmid10352167">{{cite journal| author=Corcoran C, Grinspoon S| title=Treatments for wasting in patients with the acquired immunodeficiency syndrome. | journal=N Engl J Med | year= 1999 | volume= 340 | issue= 22 | pages= 1740-50 | pmid=10352167
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=10352167 }} </ref>


In men, it is associated with [[hypogonadism]] and has been treated with supplemental [[androgen]]s. <ref>{{citation
In men, it is associated with [[hypogonadism]] and has been treated with [[androgen]]s and [[anabolic agent]]s.<ref name="pmid16235407">{{cite journal| author=Johns K, Beddall MJ, Corrin RC| title=Anabolic steroids for the treatment of weight loss in HIV-infected individuals. | journal=Cochrane Database Syst Rev | year= 2005 | volume=  | issue= 4 | pages= CD005483 | pmid=16235407
  | title = Effects of Androgen Administration in Men with the AIDS Wasting Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=16235407 | doi=10.1002/14651858.CD005483 }} </ref><ref>{{citation  | title = Effects of Androgen Administration in Men with the AIDS Wasting Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial | author = Grinspoon, S. ''et al.''  | date = 1 July 1998| volume=129 | issue=1 |  pages=18-26 | journal = Annals of Internal Medicine | url = http://www.annals.org/cgi/content/full/129/1/18?ck=nck}}</ref>  Low androgen levels also have been observed in women, and clinical trials of testosterone patches have shown promise. <ref>{{citation
| author = Grinspoon, S. ''et al.''
| journal = Journal of Clinical Endocrinology & Metabolism  | volume= 83 | date = August 1983
  | date = 1 July 1998  
| issue = 8 | pages = 2717-2725 | title = Transdermal Testosterone Administration in Women with Acquired Immunodeficiency Syndrome Wasting: A Pilot Study | author = Miller, K. ''et al.'' | http://jcem.endojournals.org/cgi/content/full/83/8/2717|http://jcem.endojournals.org/cgi/content/full/83/8/271}}</ref> A [[systematic review]] by the [[Cochrane Collaboration]] concluded "these results suggest that anabolic steroids may be useful in the treatment of weight loss in HIV infected individuals, due to limitations, treatment recommendations cannot be made."<ref name="pmid16235407">{{cite journal| author=Johns K, Beddall MJ, Corrin RC| title=Anabolic steroids for the treatment of weight loss in HIV-infected individuals. | journal=Cochrane Database Syst Rev | year= 2005 | volume=  | issue= 4 | pages= CD005483 | pmid=16235407
| volume=129  
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=16235407 | doi=10.1002/14651858.CD005483 }} </ref>
| issue=1 |  pages=18-26
| journal = Annals of Internal Medicine | url = http://www.annals.org/cgi/content/full/129/1/18?ck=nck}}</ref>  Low androgen levels also have been observed in women, and clinical trials of testosterone patches have shown promise. <ref>{{citation
| journal = Journal of Clinical Endocrinology & Metabolism  
  | volume= 83
| date = August 1983
| issue = 8 | pages = 2717-2725
| title = Transdermal Testosterone Administration in Women with Acquired Immunodeficiency Syndrome Wasting: A Pilot Study
| author = Miller, K. ''et al.''
| http://jcem.endojournals.org/cgi/content/full/83/8/2717|http://jcem.endojournals.org/cgi/content/full/83/8/271}}</ref>


There is considerable interest in the use of [[marijuana]] for the syndrome, and there is substantial use outside formal trials. It has been difficult, however, to get approval for trials.
Regarding, treatment with [[human growth hormone]], "the evidence supports a role for rhGH in the treatment of patients with HIV-associated wasting."<ref name="pmid18158071">{{cite journal| author=Gelato M, McNurlan M, Freedland E| title=Role of recombinant human growth hormone in HIV-associated wasting and cachexia: pathophysiology and rationale for treatment. | journal=Clin Ther | year= 2007 | volume= 29 | issue= 11 | pages= 2269-88 | pmid=18158071
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=18158071 | doi=10.1016/j.clinthera.2007.11.004 }} </ref>
 
If diarrhea is involved, [[zinc]] supplementation has helped in some trials of children<ref name="pmid16310552">{{cite journal| author=Bobat R, Coovadia H, Stephen C, Naidoo KL, McKerrow N, Black RE et al.| title=Safety and efficacy of zinc supplementation for children with HIV-1 infection in South Africa: a randomised double-blind placebo-controlled trial. | journal=Lancet | year= 2005 | volume= 366 | issue= 9500 | pages= 1862-7 | pmid=16310552
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=16310552 | doi=10.1016/S0140-6736(05)67756-2 }} </ref> Zinc has not been found helpful in adults<ref name="pmid16940855">{{cite journal| author=Cárcamo C, Hooton T, Weiss NS, Gilman R, Wener MH, Chavez V et al.| title=Randomized controlled trial of zinc supplementation for persistent diarrhea in adults with HIV-1 infection. | journal=J Acquir Immune Defic Syndr | year= 2006 | volume= 43 | issue= 2 | pages= 197-201 | pmid=16940855
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=16940855 | doi=10.1097/01.qai.0000242446.44285.b5 }} </ref><ref name="pmid10197378">{{cite journal| author=Kelly P, Musonda R, Kafwembe E, Kaetano L, Keane E, Farthing M| title=Micronutrient supplementation in the AIDS diarrhoea-wasting syndrome in Zambia: a randomized controlled trial. | journal=AIDS | year= 1999 | volume= 13 | issue= 4 | pages= 495-500 | pmid=10197378
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=10197378 }} </ref>.
 
There is interest in the use of [[marijuana]] for the syndrome.<ref name="pmid12873153">{{cite journal| author=Hall W, Degenhardt L| title=Medical marijuana initiatives : are they justified? How successful are they likely to be? | journal=CNS Drugs | year= 2003 | volume= 17 | issue= 10 | pages= 689-97 | pmid=12873153
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=12873153 }} </ref>. However, no trials have been published as of March, 2010.


==References==
==References==
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Latest revision as of 16:00, 24 August 2024

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According to Medical Subject Headings, HIV wasting syndrome, also called AIDS wasting syndrome, is a complication of Acquired Immune Deficiency Syndrome that is defined as "involuntary weight loss of greater than 10 percent associated with intermittent or constant fever and chronic diarrhea or fatigue for more than 30 days in the absence of a defined cause other than human immunodeficiency virus infection. A constant feature is major muscle wasting with scattered myofiber degeneration. A variety of etiologies, which vary among patients, contributes to this syndrome."[1][2]

In men, it is associated with hypogonadism and has been treated with androgens and anabolic agents.[3][4] Low androgen levels also have been observed in women, and clinical trials of testosterone patches have shown promise. [5] A systematic review by the Cochrane Collaboration concluded "these results suggest that anabolic steroids may be useful in the treatment of weight loss in HIV infected individuals, due to limitations, treatment recommendations cannot be made."[3]

Regarding, treatment with human growth hormone, "the evidence supports a role for rhGH in the treatment of patients with HIV-associated wasting."[6]

If diarrhea is involved, zinc supplementation has helped in some trials of children[7] Zinc has not been found helpful in adults[8][9].

There is interest in the use of marijuana for the syndrome.[10]. However, no trials have been published as of March, 2010.

References

  1. ↑ Anonymous (2024), HIV wasting syndrome (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ Corcoran C, Grinspoon S (1999). "Treatments for wasting in patients with the acquired immunodeficiency syndrome.". N Engl J Med 340 (22): 1740-50. PMID 10352167.
  3. ↑ 3.0 3.1 Johns K, Beddall MJ, Corrin RC (2005). "Anabolic steroids for the treatment of weight loss in HIV-infected individuals.". Cochrane Database Syst Rev (4): CD005483. DOI:10.1002/14651858.CD005483. PMID 16235407. Research Blogging.
  4. ↑ Grinspoon, S. et al. (1 July 1998), "Effects of Androgen Administration in Men with the AIDS Wasting Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial", Annals of Internal Medicine 129 (1): 18-26
  5. ↑ Miller, K. et al. (August 1983), "Transdermal Testosterone Administration in Women with Acquired Immunodeficiency Syndrome Wasting: A Pilot Study", Journal of Clinical Endocrinology & Metabolism 83 (8): 2717-2725
  6. ↑ Gelato M, McNurlan M, Freedland E (2007). "Role of recombinant human growth hormone in HIV-associated wasting and cachexia: pathophysiology and rationale for treatment.". Clin Ther 29 (11): 2269-88. DOI:10.1016/j.clinthera.2007.11.004. PMID 18158071. Research Blogging.
  7. ↑ Bobat R, Coovadia H, Stephen C, Naidoo KL, McKerrow N, Black RE et al. (2005). "Safety and efficacy of zinc supplementation for children with HIV-1 infection in South Africa: a randomised double-blind placebo-controlled trial.". Lancet 366 (9500): 1862-7. DOI:10.1016/S0140-6736(05)67756-2. PMID 16310552. Research Blogging.
  8. ↑ Cárcamo C, Hooton T, Weiss NS, Gilman R, Wener MH, Chavez V et al. (2006). "Randomized controlled trial of zinc supplementation for persistent diarrhea in adults with HIV-1 infection.". J Acquir Immune Defic Syndr 43 (2): 197-201. DOI:10.1097/01.qai.0000242446.44285.b5. PMID 16940855. Research Blogging.
  9. ↑ Kelly P, Musonda R, Kafwembe E, Kaetano L, Keane E, Farthing M (1999). "Micronutrient supplementation in the AIDS diarrhoea-wasting syndrome in Zambia: a randomized controlled trial.". AIDS 13 (4): 495-500. PMID 10197378.
  10. ↑ Hall W, Degenhardt L (2003). "Medical marijuana initiatives : are they justified? How successful are they likely to be?". CNS Drugs 17 (10): 689-97. PMID 12873153.
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