Body wasting, characterized by loss of body cell mass, is a frequent accompaniment to infection with HIV and is a factor in survival itself. Periods of rapid weight loss are typically associated with episodes of secondary infection. Chronic weight loss is usually the result of gastrointestinal disorders. Increased rates of resting energy expenditure and alterations in lipid, protein, and carbohydrate metabolism have been noted in persons with HIV infection. However, no statistical association has been demonstrated between these alterations and the wasting syndrome. Therapies that increase energy intake can increase body weight but do not consistently restore body cell mass. Treatment with recombinant human growth hormone has increased body weight, nitrogen retention, and lean body mass in patients with the wasting syndrome. If these promising results can be sustained during long-term therapy, anabolic agents such as recombinant human growth hormone may be effective in reversing or forestalling HIV-associated wasting.
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