2nd Workshop on Nutrition and Quality of Life in HIV Infection: The Role of Growth Hormone in HIV-associated Wasting, Berlin, Germany, 6-7 March, 1998

G. E. Griffin, N. I. Paton, Jr Cofrancesco J., K. Arasteh, G. Bauer, A. Schwenk, S. Mauss, K. Mulligan

Research output: Contribution to journalArticlepeer-review

Abstract

Assessment of total free living energy, rather than resting energy, expenditure shows that HIV-positive patients who are experiencing weight losses are expending less energy than patients experiencing weight gain, disproving the concept that high energy expenditure provokes inexorable weight loss in HIV-positive patients. Further studies show that patients who are losing weight not only have a reduced energy intake but are also in profound energy deficit despite having reduced their total energy expenditure. One means of reversing this fatal trend is to increase energy intake, although the metabolic consequences of this course of action remain to be determined. Controversy still surrounds the choice of parameter for assessing nutritional status; however, newer techniques for assessing body cell mass (BCM) and quality of life (QoL) should assist in selecting outcomes that are reliable, simpler to perform and reproducible. As outcomes, these values can then be compared. Antiretroviral therapy, while clearly impacting on patient survival and QoL, is having a less obvious effect on wasting. While it is apparent that protease inhibitors (PIs), in particular, are associated with weight gains, such gains are predominantly of fat and may be associated with induction of metabolic syndromes. Further studies are awaited. There is increasing evidence that recombinant human growth hormone (rhGH), given to stable patients and to patients with opportunistic infections, is associated with improvements in BCM, which in turn is associated with increased survival in HIV+ patients. A review of the therapeutics available to patients with HIV-associated wasting shows that a number of drugs can produce positive benefits.

Original languageEnglish (US)
Pages (from-to)199-218
Number of pages20
JournalJournal of Clinical Research
Volume1
Issue number199-218
StatePublished - 1998
Externally publishedYes

Keywords

  • Antiretroviral therapy
  • HIV-associated wasting
  • Metabolism
  • Nutrition
  • Recombinant human growth hormone

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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