title: HIV wasting syndrome: treatment update.
abstract: OBJECTIVE
  To review the pathophysiology and treatment of HIV wasting syndrome.
  
  
  METHODS
  MEDLINE searches (January 1987-September 1997) of the English-language medical literature were conducted. Bibliographies were also selected during a manual review.
  
  
  RESULTS
  HIV-related weight loss, often referred to as HIV wasting syndrome, is a common manifestation of advanced HIV infection. Wasting in HIV involves the preferential loss of lean body mass with a paradoxical preservation of body fat. The etiology of wasting appears to be the result of many factors, which may include decreased caloric intake, malabsorption, alterations in energy expenditure and metabolism, cytokine effects, and endocrine dysfunction. Pharmacologic treatment options include appetite stimulants (e.g., dronabinol, megestrol acetate), cytokine inhibitors (e.g., thalidomide, cyproheptadine, ketotifen, pentoxifylline, fish oil, N-acetylcysteine), and anabolic agents (e.g., testosterone, nandrolone, oxandrolone, recombinant human growth hormone).
  
  
  CONCLUSIONS
  Wasting associated with HIV has a high morbidity and mortality rate if not adequately managed. Therapeutic strategies include appetite stimulants, cytokine inhibitors, and growth-promoting agents. Selection of the appropriate agent(s) depends on the underlying cause for weight loss, adverse effects, and cost of therapy.
authors.affiliation: Montefiore Medical Center, Bronx, NY 10467, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Balog
authors.forename: M E
authors.initials: ME
authors.lastname: Epstein
authors.forename: M I
authors.initials: MI
authors.lastname: Amodio-Groton
mesh_terms: D015658:HIV Infections / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D015431:Weight Loss