Causes of weight loss in HIV infection

Autor: G.E. Griffin, D.C. Macallan
Rok vydání: 1994
Předmět:
Zdroj: Clinical Nutrition. 13:198
ISSN: 0261-5614
DOI: 10.1016/0261-5614(94)90106-6
Popis: Weight loss is a major clinical manifestation of HIV infection. It has classically been accepted that progressive gradual weight loss is the common pattern observed during the course of the infection and several studies have demonstrated such weight loss in groups of individuals with HIV infection and suggested a relationship between loss of weight and timing of death (1,2). We have recently followed prospectively weight change in a cohort of HIV infected male homosexuals over a 2 year period and correlated Body Mass Index (kg/m*) with clinical events (3). We have demonstrated periods of acute weight loss (median 13% body weight, median 9.3 kg) associated classically with acute infection. Following such periods of acute weight loss, 50% (17 of 33) gained weight and of these patients 65% returned to their pre-acute event body weight but a small number never regained weight. Chronic progressive weight loss was demonstrated in patients with gastrointestinal disease which has already been shown to be important in HIV infection (4,5). In a separate series of experiments we have measured resting energy expenditure (REE) (indirect calorimetry) and rates of whole body protein synthesis (t3C Leucine infusion) in the post-absorptive state and in response to intravenous nutrition. We have confirmed previous reports of an increase in REE in HIV infection (5-10% above predicted values) (6). In addition we have shown that even in weight-losing HIV infected patients there is an increment of whole
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