Reviewer: Li Xin (Beijing Ditan Hospital Affiliated to Capital Medical University)
AIDS wasting syndrome does not refer to a specific disease. When people with AIDS lose at least 10% of their body weight (especially muscle loss), it’s called wasting syndrome.
Wasting syndrome may be accompanied by diarrhea for more than a month, or extreme weakness not related to infection.
The exact cause of the disease is unknown, but thanks to the availability of antiretroviral therapy (ART), it is less common now. However, it remains a serious threat to people living with AIDS, leading to increased chances of opportunistic infections, dementia and death.
For HIV-infected people, losing even 5% of body weight can increase the chance of these problems.
So HIV patients must pay attention to their weight, pay attention to their daily diet, and eat on time even if they are not hungry. If you experience sudden weight loss, severe diarrhea, or a gastrointestinal infection, you should seek medical attention.
Image source: Zhanku Hailuo
I. Etiology
Perhaps the most important reason is not receiving ART medication, so it is best not to miss a single dose.
Little food intake, resulting in insufficient intake of nutrients the body needs, is also a common cause.
HIV-infected people metabolize faster than normal, either because the infected person’s immune system is working harder, or because the HIV virus affects the hormones that control the body’s metabolism.
Regardless of the reason, patients need to consume more calories to maintain their weight. This can sometimes be a problem, because HIV often affects the appetite of infected people.
Other causes of poor appetite and weight loss include:
Drug side effects such as nausea, changes in taste, or tingling in the mouth;
Symptoms of opportunistic infections, such as sore throat or bloating;
Lack of money or lack of energy to eat;
Depression.
In some patients, the cause is the body’s inability to absorb nutrients from food. HIV can damage the lining of the digestive tract, or infection can reduce the ability to absorb nutrients. There are also medicines that can cause diarrhea.
HIV-infected people tend to have high levels of cytokines. Cytokines can induce the body to synthesize more fats and carbohydrates, but less protein, which proves to be the main component of muscle.
2. Diagnosis
The doctor will ask the patient questions about diet, medications being taken, and recent mood.
A doctor may perform a body composition test to check the distribution of tissue in the body. One such test is bioelectrical impedance analysis (BIA), in which the patient is placed in a lying position and the examiner measures how painless electrical signals travel through the patient’s body. HIV patients should go to a facility with experience in the treatment of AIDS wasting syndrome for such testing.
Doctors may also order other tests to see if the patient is having problems absorbing nutrients.
Image source: Zhanku Hailuo
Third, treatment
Megestrol acetate is an appetite stimulant. However, some doctors do not recommend this drug because it can increase body fat and reduce hormone production by the gonads.
A doctor may adjust a patient’s ARTmedication to avoid or reduce diarrhea. Patients should also be aggressively treated for opportunistic infections that can affect the gastrointestinal tract.
Changing your diet can also help prevent and relieve diarrhea. Reduce your intake of fat, lactose (found in dairy products), insoluble fiber (found mostly in whole grains), and some vegetables.
Increase your intake of soluble fiber from oat bran, nuts, lentils and peas, certain vegetables and fruits. Stay away from caffeine, alcohol, and desserts high in sugar.
If you cannot get enough nutrients, consider using nutritional supplements (such as Ansu, which provides nutritional support for people living with HIV) instead.
Image source: Zhanku Hailuo
Fourth, increase muscle
Growth hormone is a human growth hormone that increases both total and lean body mass (weight excluding fat) in patients. But it’s expensive and can raise blood sugar levels, causing muscle and joint pain.
Progressive strength training helps increase lean body mass, and the trainer gets stronger and stronger by gradually increasing the load, reps, and sets.
Hormones and anabolic steroids help build muscle, but because of their association with sex hormones, they may cause infertility in men or menstrual irregularities in women. They also lower levels of “good cholesterol” (HDL).
Thalidomide reduces cytokine levels, but the downside is that it may cause muscle weakness and a tingling or burning sensation in the arms or legs.
*The content of this article is for the popularization of health knowledge and cannot be used as a specific diagnosis and treatment suggestion, nor can it replace the face-to-face consultation of a licensed physician, and is for reference only.
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