Treatment with nandrolone decanoate and megestrol acetate in HIV-infected men.
BACKGROUND
Malnutrition, especially loss of lean body mass, is a frequent complication of people living with HIV that may increase their mortality and morbidity.


METHODS
Nine HIV-infected men with unexplained loss of >10% of their usual weight were selected. They received megestrol acetate (MA) (400 mg/day by mouth) and nandrolone decanoate (ND) (100 mg/15 days intermuscular injection) over 16 weeks. Anthropometric evaluations, bioelectrical impedance, grip strength dynamometry, hematologic, biochemical, immunological and hormonal analysis before, during, and after the treatment were performed. Quality of life was evaluated by the Karnofsky index.


RESULTS
In the 7 men that finished the treatment, there were significant increases in weight (11.9 +/- 9.1 kg, p < .05), 4-site skinfold measurements (p < .05), midarm circumference (p < .005), and fat-free mass (FFM) (5.1 +/- 4.1 kg, p < .05). The increase in fat mass was not statistically significant (6.9 +/- 6.4 kg, NS). Muscle strength increased significantly (p < .005). The Karnofsky index values increased from 59% to 73% (p < .05). One patient developed mild hyperglycemia and another one had an increase in aspartate transaminase and gamma-glutamyl transpeptidase that reversed after the treatment. Four patients developed asymptomatic adrenal suppression. Testosterone serum levels decreased significantly during the study (p < .05), and 4 patients had serum values below the normal range at week 16. One patient developed gynecomastia.


CONCLUSIONS
The combined treatment with MA and ND led to a significant increase in body weight and FFM. Muscle strength and quality of life improved during the study. The treatment was well tolerated with mild side effects.
Cuerda
Cristina
C
Nutrition Unit, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain. mcuerda.hgugm@salud.madrid.org
Zugasti
Ana
A
Bretón
Irene
I
Camblor
Miguel
M
Miralles
Pilar
P
García
Pilar
P
D000328:Adult; D045930:Anabolic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000886:Anthropometry; D019167:Appetite Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications; D019247:HIV Wasting Syndrome / Q000188:drug therapy*; D006801:Humans; D008297:Male; D019290:Megestrol Acetate / Q000009:adverse effects / Q000627:therapeutic use*; D018482:Muscle, Skeletal / Q000187:drug effects / Q000254:growth & development / Q000378:metabolism; D009277:Nandrolone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077603:Nandrolone Decanoate; D011788:Quality of Life; D012449:Safety; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
D045930:Anabolic Agents; D019167:Appetite Stimulants; D013739:Testosterone; D009277:Nandrolone; D000077603:Nandrolone Decanoate; D019290:Megestrol Acetate