HIV-related wasting is a consequence of an abnormal metabolism, in which the body's ability to process carbohydrates, proteins and fats and ultimately to produce energy and build tissue has been altered. This can lead to:
Unintended weight loss of more than 10 percent of total body weight that occurs with diarrhea or chronic weakness and fever for at least 30 days and that is not as a result of a non-HIV condition. This weight can be hard to gain back.
Lowered physical endurance
Loss of lean body mass, including muscle
People experiencing such weight loss may have little or no appetite.
Wasting syndrome was a major health problem among people with HIV during the first 15 years of the AIDS epidemic, when there were no adequate treatments for the virus. Even though wasting syndrome is now much less common thanks to modern antiretroviral (ARV) treatment for HIV, it still occurs in a small proportion of people living with the virus. Even those with higher CD4 counts and lower viral loads may experience HIV-associated wasting.
Significant weight loss can be a major detriment to an individual's quality of life.
What causes wasting syndrome?
Scientists don't have the firmest grasp on what causes wasting. It appears to have many overlapping causes. Possible contributing factors include
Proinflammatory cytokines—this is a natural immune response that HIV prompts, even when it is fully suppressed by ARVs
Low hormone levels, such as testosterone levels
The body's resistance to growth hormone
A rise in how many calories the body burns at rest, known as resting energy expenditure (REE)
Recreational drug use
Depression and isolation
Loss of appetite
Reduced food intake as a result of nausea (a common side effect of HIV medications), depression, fatigue, altered taste perception, social isolation or inability to purchase adequate food
Difficulty swallowing, possibly because of symptoms from oral and esophageal conditions such as candidiasis and aphthous ulcers
Diarrhea, which is a common side effect of HIV medications. Also, HIV causes immediate and largely permanent damage to the gut shortly after infection, raising the overall risk of diarrhea among those living with the virus.
Last Revised: November 10, 2015
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