Resource Logo
NLM AIDSLINE

Hormonal anabolic agents and cytokine inhibitors in the treatment of HIV-associated wasting.




 

3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:171. Unique

Although the pathogenesis of wasting in patients with HIV infection is multifactorial, a reduction of energy intake appears to be the major contributor during periods of weight loss. Appetite stimulants such as megestrol acetate can increase body weight, but result in a predominant accrual of fat. Treatment with recombinant human growth hormone (rhGH) caused weight gain and nitrogen (N) retention in a metabolic ward setting and a sustained increase in lean body mass in a randomized placebo controlled trial, thus indicating the presence of considerable anabolic potential in HIV wasted patients. Notably, rhGH exerted these effects without reversing the characteristic metabolic perturbations in such patients. Insulin like growth factor-I which mediates many of the anabolic and metabolic effects of GH caused transient N retention in a metabolic ward study but side effects limit its benefit. Many anecdotal reports indicate a salutary effect of testosterone and synthetic anabolic steroids but placebo controlled trials are sorely lacking and the need for concomitant resistance exercise in mediating the anabolic effects is as yet undefined. Thus, although the ability of hormonal agents to exert an anabolic effect in patients with HIV-associated wasting represents an important therapeutic advance, it continues to be important to evaluate alternative therapies that are more focused on the underlying pathophysiology. Administration of agents that reduce cytokine production represents a means of testing the hypothesized.

Anabolic Steroids/PHARMACOLOGY/*THERAPEUTIC USE Cachexia/BLOOD/*DRUG THERAPY Cytokines/*ANTAGONISTS & INHIB HIV Infections/BLOOD/*COMPLICATIONS Human Megestrol/THERAPEUTIC USE Pentoxifylline/PHARMACOLOGY/THERAPEUTIC USE RNA, Messenger/BLOOD Thalidomide/PHARMACOLOGY/THERAPEUTIC USE Tumor Necrosis Factor/GENETICS ABSTRACT



 




Information in this article was accurate in November 30, 1996. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.