AIDS wasting syndrome

AIDS wasting syndrome occurs when you have AIDS and lose at least 10% of your body weight - especially muscle. You may also have at least 30 days of diarrhoea or extreme weakness and fever that's not related to an infection. AIDS wasting syndrome is not a specific disease, and is a poorly understood condition of AIDS (acquired immunodeficiency syndrome). It is less frequent than in the past, thanks to anti- HIV (human immunodeficiency virus) medications, called highly active antiretroviral therapy (HAART). But it is still a significant threat. It increases the risk of opportunistic infections, lowered intellectual function, and death. Even a weight loss of 5% can increase these risks. However, you can take several steps to reduce your risks.

What causes AIDS wasting syndrome?

If you have AIDS, the following factors can work together to promote weight loss.

Not eating enough. It may be difficult to get adequate nutrition for reasons such as these:

• Poor appetite from HIV infection
• Side effects of medicines, such as nausea, changes in taste, or tingling of the mouth
• Opportunistic infection symptoms, such as a painful throat or sense of fullness
• Lack of money or energy to shop for and prepare meals
• Depression

Not absorbing nutrients well. This may happen because:

• HIV directly affects the intestinal lining.
• Opportunistic infections interfere with absorption.
• Medications cause diarrhoea, which leads to a loss of calories and nutrients.

Changes in metabolism. This can occur for many reasons.

• HIV disease burns calories quickly, so you need more calories to maintain your body weight. This need for extra calories may be due to the increased activity of the immune system. Or it may be because HIV changes levels of hormones that affect how fast you burn calories.
• People with HIV have high levels of proteins called cytokines. These make your body produce more fats and sugars, but fewer proteins.

Diagnosing AIDS wasting syndrome

To diagnose AIDS wasting syndrome, your doctor will ask you about your history, finding out about your diet, the medicines you're taking, and whether you've been depressed, for example.

You may also have tests to identify problems with nutrient absorption.

Treating AIDS wasting syndrome

It's important to monitor your weight and maintain healthy eating habits-even when you're not hungry. See your doctor straight away if you lose weight, have severe diarrhoea, or have an opportunistic infection affecting your gastrointestinal system.

To treat AIDS wasting syndrome, your doctor will use a variety of approaches:

To increase appetite or reduce nausea and vomiting, your doctor may suggest:

• Megestrol acetate, an appetite stimulant that is a synthetic form of progesterone. This may sometimes increase body fat and decrease release of hormones from sex glands (hypogonadism). For these reasons, some doctors don't recommend it.

To relieve diarrhoea, your doctor may:

• Identify and treat opportunistic infections that affect the intestines.
• Make adjustments in your HAART medications.
• Suggest nutritional supplements to help make up for poor nutrient absorption.
• Suggest limiting fat, lactose, insoluble fibre (such as that found in fruits, vegetables, and whole grains), caffeine, alcohol, and concentrated sweets.